Efficacy of Surface Landmark Palpation for Identification of the Cricoid Cartilage in Obstetric Patients
Efficacy of Surface Landmark Palpation for Identification of the Cricoid Cartilage in Obstetric Patients
Rapid Sequence Induction (RSI), with cricoid pressure is advocated for all obstetric patients
 undergoing general anesthesia. Applying cricoid pressure correctly is crucial to prevent
 aspiration. Using Ultrasound guidance we will be assessing the ability of different
 disciplines of caregivers to correctly localize the cricoid cartilage in obstetric patients
 by anatomical landmark palpation.
Obstetric patients coming for elective cesarean delivery will be recruited for the study.
 Informed consent will be obtained from the patient. The participant (anesthesiologist,
 resident, nurse, or RT) will mark the center of the cricoid cartilage with the patient in the
 sniffing position, using fluorescent "invisible" ink. Another anesthesiologist who is expert
 in using ultrasound will find the proximal and distal margins of the cricoid cartilage an
 will draw a line at the middle of the 2 margins. Evaluation of the participant's assessment
 will be considered accurate if it falls within 5 mm from the ultrasound's measured line .The
 assessor will also be asked to score the ease of cricoid cartilage palpation between 1 to 10
 using a visual analog scoring (VAS) scale. Total time taken for palpation will also be
 measured.
Inclusion Criteria:

 -  Patient 18 years and older

 -  ASA 1-2•Having singleton pregnancy.

 -  Gestational age >37.

 -  Elective cesarean section

 Exclusion Criteria:

 -  Patient refusal.

 -  Renal failure.

 -  Severe preeclampsia.

 -  Non- scheduled caesarean delivery (urgent).

 -  Twin pregnancy.