The application of cricoid pressure is a common technique used to decrease the risk of aspiration during anesthetic induction. Research recommends that 3 to 4 kg of cricoid force be applied to achieve effective esophageal occlusion. The purpose of this study was to assess perioperative nurses' knowledge regarding the recommended amount of cricoid force that should be applied to the cricoid cartilage and to assess the amount of force generated when cricoid pressure was applied to a scale-mounted model. A convenience sample of 102 perioperative nurses participated in the study. Five percent of participants identified the correct amount of force necessary. Applied force was significantly less than the recommended amount. Findings of this study suggest perioperative nurses lack both knowledge and clinical skill for generating effective amounts of cricoid force.

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Benzocaine administration to facilitate upper endoscopic procedures can result in the relatively uncommon but potentially fatal complication known as methemoglobinemia. For this reason, the Veterans Health Administration (VA) announced on February 8, 2006, that they would stop using benzocaine-containing sprays for procedures involving the mouth and throat. Methemoglobinemia should be considered in any patient who demonstrates cyanosis, respiratory distress, headache, lightheadedness, and a dark, chocolate-colored blood after receiving pharyngeal anesthesia. Prompt recognition of this rare (but potentially fatal) condition is important. Once identified, treatment is generally rapid with methylene blue. The patient should be monitored in the intensive care setting for recurrence. Knowledge of this adverse medication reaction is essential for all gastroenterology nurses.