Topic > The main concerns and implications of implementing cricoid pressure

CP is considered a standard of care in many areas of the world, especially in the United Kingdom, North America and Australia. However, it is not standard practice elsewhere and remains a controversial issue. Its performance appears to be declining in Europe and some prehospital organizations do not approve its use. CP may also not be a common practice in regions where there are no qualified healthcare workers to assist the anesthetist. Overall, concerns in implementing CP include difficulties in laryngoscopy, lack of concrete evidence of its effectiveness, potentially increased risk of reflux, and deterioration of unnoticed trauma in the larynx or cervical spine. Furthermore, concerns about the accurate application of cricoid force, patient discomfort, and increased physical and cognitive workload on healthcare providers make CP anything but a “simple maneuver that can be taught to a assistant in seconds”, as once perceived. . In recently published guidelines from various international societies, including the 2015 Airway Management Guidelines of the Council of the German Society of Anesthesiology and Intensive Care and the 2015 Resuscitation Guidelines of the European Resuscitation Council, the routine use of CP is no longer recommended. It is clear that these guidelines reflect the skepticism of the corresponding medical societies regarding the safety and effectiveness of this technique. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essay This could have significant medicolegal implications as a doctor could no longer be accused of failing to use CP. Based on the results of non-RCT studies, a recent Cochrane systematic review concluded that CP may not be essential for performing RSI safely. It is recognized that there are two schools of thought on the benefits of CP. It is true that there are no randomized controlled trials demonstrating the favorable outcomes of CP in terms of patient safety and efficacy, and the level of evidence to encourage the application of CP is poor. Due to ethical constraints, such studies are highly unlikely to gain approval. Even if such a study were conducted, it would not reveal much information due to practical problems. Therefore, the efficiency of CP should be evaluated by other means. On the other hand, reports of CP's preventative role in gastric insufflation make it difficult to confidently argue against its efficacy. We recognize that the use of CP may hinder some aspects of airway management, especially when it is poorly applied; however, any complications are reversible as soon as they are removed. One of the major issues in evaluating the overall efficiency of CP is to investigate whether CP successfully meets its primary objective of reducing the risk of gastric regurgitation and pulmonary aspiration. It is clear that CP cannot completely eliminate this risk. In numerous studies, regurgitation occurred even with the application of CP. We cannot deny that, ideally, regurgitation situations should be eliminated. However, these high expectations do not need to be met to demonstrate the effectiveness of CP. As long as CP can be shown to decrease the incidence of regurgitation without causing complications, this approach can continue to be considered a beneficial maneuver. Basically, CP is a technique that completely occludes the hypopharyngeal lumen, preventing the passage of gastroesophageal contents. The rationale behind CP was.