RSI - Does ultrasound improve identifcation of conventional landmarks?
Research type
Research Study
Full title
Ultrasound in RSI: Does Ultrasound imaging improve the localisation of cricoid cartilage in comparison to traditional landmark technique?
IRAS ID
147821
Contact name
Ashok Nair
Contact email
Sponsor organisation
Burton Hospitals NHS Foundation Trust
Duration of Study in the UK
0 years, 10 months, 30 days
Research summary
Induction of general anaesthesia (going to sleep for an operation) always carries a risk of aspiration of stomach contents into the airway (windpipe) until the airway is isolated using a tube (endotracheal tube) from the food pipe (oesophagus). This is due to the loss of the normal protective gag and cough reflex after induction of general anaesthesia. Certain factors specifically increase the risk of aspiration (e.g. surgery on stomach and bowels, emergency surgery, full stomach etc.) Anaesthetists normally device contingency plans to minimise the risk of this complication happening if proceeding with the surgery is in the patient's best interests. One of the strategies used for over 50 years is called the ‘Rapid Sequence Induction (RSI)’ where a patient is drifted off to sleep with rapidly acting anaesthetic drugs and moderate pressure is simultaneously applied to the front of the neck on a particular point called the cricoid cartilage by a trained anaesthetic assistant. The aim of applying pressure on the cricoid cartilage is to use this structure to potentially block the food pipe which is normally situated behind it and therefore prevent any backflow of stomach contents.
Cricoid cartilage is traditionally identified using landmark technique and knowledge of surface anatomy. We want to investigate if the use of ultrasound imaging can help improve accuracy of identification of the cricoid cartilage. Ultrasound imaging is a non-invasive means of seeing structures in the body using images generated by sound waves on a screen. There is no radiation involved and it is commonly used by anaesthetists to cannulate veins and locate nerves. To date there is no evidence that it has any harmful effect on the human body. Indeed it is the preferred technique to monitor the growth of foetus in pregnant women in the UK.
REC name
Yorkshire & The Humber - Leeds West Research Ethics Committee
REC reference
14/YH/1298
Date of REC Opinion
11 Dec 2014
REC opinion
Further Information Favourable Opinion