The Efficacy of Cricoid Pressure in Preventing Gastro-Oesophageal Reflux in Rapid Sequence Induction of Anaesthesia

2007 ◽  
Vol 17 (9) ◽  
pp. 432-436 ◽  
Author(s):  
Luke Ewart
Keyword(s):  
General Anaesthesia ◽  
Cricoid Pressure ◽  
Cricoid Cartilage ◽  
Rapid Sequence Induction ◽  
Evidence Base ◽  
Short Article ◽  
Rapid Sequence ◽  
Sequence Induction ◽  
Risk Of Aspiration ◽  
Induction Of Anaesthesia

Aspiration pneumonitis (AP) is a recognised complication of general anaesthesia (GA) that has an associated morbidity and mortality. Sellick's manoeuvre – the application of a sustained pressure to the cricoid cartilage – is one commonly taught anaesthetic practice that is deemed to reduce this risk of aspiration. However, this practice is not without its failings and some of the evidence base surrounding the use of cricoid pressure is examined in this short article.

scholarly journals Rapid sequence induction: where did the consensus go?

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Pascale Avery ◽  
Sarah Morton ◽  
James Raitt ◽  
Hans Morten Lossius ◽  
David Lockey
Keyword(s):  
Cricoid Pressure ◽  
Rapid Sequence Induction ◽  
Hospital Environment ◽  
Training Technique ◽  
Rapid Sequence ◽  
Gastric Aspiration ◽  
Sequence Induction ◽  
The Uk ◽  
Key Aspects ◽  
Risk Of Aspiration

Abstract Background Rapid Sequence Induction (RSI) was introduced to minimise the risk of aspiration of gastric contents during emergency tracheal intubation. It consisted of induction with the use of thiopentone and suxamethonium with the application of cricoid pressure. This narrative review describes how traditional RSI has been modified in the UK and elsewhere, aiming to deliver safe and effective emergency anaesthesia outside the operating room environment. Most of the key aspects of traditional RSI – training, technique, drugs and equipment have been challenged and often significantly changed since the procedure was first described. Alterations have been made to improve the safety and quality of the intervention while retaining the principles of rapidly securing a definitive airway and avoiding gastric aspiration. RSI is no longer achieved by an anaesthetist alone and can be delivered safely in a variety of settings, including in the pre-hospital environment. Conclusion The conduct of RSI in current emergency practice is far removed from the original descriptions of the procedure. Despite this, the principles – rapid delivery of a definitive airway and avoiding aspiration, are still highly relevant and the indications for RSI remain relatively unchanged.

scholarly journals Preoperative management and features of induction of anaesthesia in acute bowel obstruction (clinical lecture)

2021 ◽  
Vol 16 (7-8) ◽  
pp. 18-32
Author(s):  
M.М. Pylypenko ◽  
M.V. Bondar
Keyword(s):  
General Anaesthesia ◽  
Bowel Obstruction ◽  
Rapid Sequence Induction ◽  
Arterial Hypotension ◽  
Infusion Therapy ◽  
Electrolyte Disturbances ◽  
Vital Functions ◽  
Rapid Sequence ◽  
Abdominal Hypertension ◽  
Induction Of Anaesthesia

This article presents the main approaches to the pre-operative preparation of patients with severe acute bowel obstruction and emphasizes that this preparation should be limited in time and don’t delay the surgery. In severe bowel obstruction, in addition to a thorough assessment of vital functions and determination of leading physiologic disorders, it is extremely important to examine patients using specific scales which allow determining the risks of major complications. General anaesthesia usually is the method of choice for acute bowel obstruction; however, it could be supplemented by regional anaesthesia to improve intra- and postoperative pain relief. While preparing for general anaesthesia, first of all, it is necessary to determine the risks of difficult airway and complicated intubation, as well as regurgitation and aspiration of gastric contents, which allows you to purposefully approach the choice of intubation techniques and prevent the occurrence of these formidable complications. Sellick’s manoeuvre is no longer required in these patients, and instead of it during intubation, bimanual laryngoscopy can be used. Arterial hypotension is a common complication during induction of anaesthesia in severe bowel obstruction, and such patients should always be treated with infusion therapy, and their fluid and electrolyte disturbances should be corrected. At the same time, to prevent intestinal oedema and the development of intra-abdominal hypertension, infusion therapy should be limited both in time and in volume. If hypovolemia cannot be completely corrected, vasopressors should be given prophylactically to reduce the risk of significant arterial hypotension during rapid sequence induction.

Tonsillar Bleed

2018 ◽  
Author(s):  
Titilopemi A. O. Aina ◽  
Sharon Redd
Keyword(s):  
Risk Factors ◽  
Rapid Sequence Induction ◽  
Male Gender ◽  
Recurrent Tonsillitis ◽  
Surgical Scar ◽  
Rapid Sequence ◽  
Secondary Bleeding ◽  
Sequence Induction ◽  
Inflammatory Drugs ◽  
Risk Of Aspiration

Post-tonsillectomy hemorrhage (PTH) is a very serious complication that can occur after a tonsillectomy. There are two broad categories of PTH, based on onset of bleeding: primary (less than 24 hours) or secondary (greater than 24 hours). Primary bleeding is often attributed to the surgical technique, and secondary bleeding is attributed to sloughing of healing surgical scar. Risk factors for PTH include male gender, age greater than 70 years (in adults), age greater than 5 years (in pediatrics), recurrent tonsillitis, use of nonsteroidal anti-inflammatory drugs (particularly ketorolac), among others. Rapid-sequence induction and intubation is advised to reduce the risk of aspiration for patients presenting with PTH.

scholarly journals Audit on Current Practice of Rapid Sequence Induction and Intubation of Anesthesia in the University of Gondar Hospital, Northwest Ethiopia, 2018

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Mamaru Mollalign ◽  
Amare Hailekiros Gebreegzi ◽  
Habtamu Getinet ◽  
Seid Adem
Keyword(s):  
Cricoid Pressure ◽  
Rapid Sequence Induction ◽  
Northwest Ethiopia ◽  
Pulmonary Aspiration ◽  
Airway Control ◽  
Elective Surgical Procedures ◽  
Rapid Sequence ◽  
Audit Period ◽  
Sequence Induction ◽  
The University

Background. In patients who are liable to the risk of pulmonary aspiration, airway control is the primary and first concern for the anesthetists both in emergency and elective surgical procedures. Rapid sequence induction is universally required in any occasion of emergent endotracheal intubation needed for unfasted patients or patients’ fasting status is unknown. Methods. institutional-based prospective observational study was conducted from December 2017 to January 2018 in all elective and emergency adult or pediatric patients with a risk of pulmonary aspiration who were operated under general anesthesia with rapid sequence induction and intubation during the audit period. Result. A total of 35 patients were operated during the study period. Of these, 31 (88.57%) patients were adults and 4 (11.43%) patients were pediatrics. Most of the patients were emergency (29 (82.857%)), and the rest were elective (6 (17.142%)). Conclusion. Most anesthetists were good at preparing all available monitoring and drugs, making sure that IV line is well-functioning, preparing suction with a suction machine, preoxygenation, application of cricoid pressure, and checking the position of the ETT after intubation was performed. Preparing difficult airway equipment during planning of rapid sequence induction and intubation, giving roles and told to proceed their assigned role for the team, attempt to ventilate with a small tidal volume, and routine use of bougie or stylet to increase the chance of success of intubation needed improvement.

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