Validation of a novel handheld device for accurate cricoid pressure application on a laryngotracheal model

Background

Cricoid pressure, manual compression of the cricoid cartilage using 30 N of force, is a well-established technique to prevent regurgitation during airway management. However, applying and maintaining the correct force has proven difficult for providers. To address this, we developed a handheld Cricoid Pressure Device, which displays applied force in real time. This study aims to assess the device in terms of its ability to aid providers in applying the correct force.

Methods

In a single center study, twenty five healthcare providers performed cricoid pressure for three 60-s trials on a laryngotracheal model under three conditions: 1) Standard condition with no training, 2) Post-Training condition following syringe model training, and 3) Cricoid Pressure Device condition using our novel device. The primary outcome was the proportion of providers applying pressure within the target range (30 ± 5 N) for at least 95 % of the trial duration. Secondary outcomes included providers’ feedback on the usability of the device.

Results

Using the Cricoid Pressure Device, 92 % of providers applied force within the target range for the third trial, compared to 4 % in the Standard condition and 8 % in the Post-training condition. A logistic mixed effects model indicated that the odds of successful application using the Device were significantly higher than the Standard condition (OR = 482.7; 95 % CI 67.7, 3442.5). All participants believed the device would be extremely useful in clinical practice.

Conclusion

The Cricoid Pressure Device significantly improved provider's ability to apply the target cricoid pressure to a laryngotracheal model compared to standard practice.