Survey of skills needed to assist tracheal intubation: nurse assistants lack accurate knowledge of BURP and cricoid pressure maneuvers
Taguchi, S.; Kusunoki, S.; Tanigawa, K.; Kawamoto, M.
Masui. Japanese Journal of Anesthesiology 59(8): 954-960
2010
ISSN/ISBN: 0021-4892 PMID: 20715518 Document Number: 646163
The backward, upward and rightward pressure (BURP) maneuver and cricoid pressure (CP) are easily confused because of their similarities. We surveyed nurses to determine their knowledge and skills regarding these maneuvers. Forty nurses (OR, n=20; ER, n=20) answered questionnaires regarding BURP and CP, and were then asked to apply CP to a laryngopharynx model equipped with a digital scale to measure compression force. As for the BURP maneuver, 26 nurses (OR 20, ER 6) noted previous experience, while only 13 (OR 3, ER 10) and 1 (OR) nurses answered correctly regarding the compression point and correct direction, respectively. As for CP, 16 nurses (OR 14, ER 2) noted previous experience, but only 3 (all ER) answered correctly. Twenty-six nurses (OR 16, ER 10) incorrectly compressed the thyroid cartilage on the laryngopharynx model, and 24 (OR 18, ER 6) incorrectly applied backward and upward pressure, which was significantly frequent among the OR nurses. The measured forces of CP were 2.11 +/- 1.3 kg (mean +/- SD) and 2.5 +/- 2.1 kg for the OR and ER nurses, respectively, which were not significantly different. We found that the nurses are confused with the BURP and CP maneuvers. Unless applied correctly, these maneuvers may interfere with tracheal intubation. Constant education and training are essential for effective and safe implementation of these maneuvers.