Research Proposal On 2014/15

1, Personal Details

Please tick where appropriate;
Contact telephone number:
Staff: Department:     
Proposed start date of Study (m/y): 11/14
Proposed end date of study (m/y): 12/14
All applications must be completed in line with the guidance notes attached as Appendix I. Applications must be submitted no later than the deadlines stipulated. Contact the Research Administrator for dates.

3, Project Details

3.1 Lay Summary
In hospital, where serious operations can occur and patient’s part of a body needs to be numbed, general anaesthesia is applied. General anaesthesia makes a person being unconsciousness by affecting his/her central nervous system (CNS). Moreover, Harvard Medical School, Weill Cornell Medical College and the Massachusetts Institute of Technology found that general anaesthesia has similar effect as coma, rather than having patient heavily sleeping. During a general anaesthesia patients are made unconscious. When general anaesthesia is applied, the function of cerebral cortex, spinal cord, reticular activating system may be affected or even interrupted. This means that patients have to been watched carefully. If the patient loses his/her swallowing reflex a vital actions are require to prevent regurgitation of the stomach content and subsequent inhalation into the patients lungs are required. In this situation a patient will be put with bag-mask ventilation. Applying cricoid pressure will help the doctors in preventing gastric content aspiration and stopping passive regurgitation.

Late applications will not be considered.

2, Additional Information
Where the project is part of an undergraduate or postgraduate course
Where the research is being carried out by a member of staff please provide details of co-investigators
3.2 Background and Objectives of Study (300 words maximum)

Cricoid cartilage pressure is a solution to preventing aspiration while under general anaesthesia.

Cricoid cartilage pressure is defined as a technique, which reduced the risk of stomach content aspiration during general anaesthesia. Sometimes it can be explained, as a mechanical method for passive regurgitation and gastric content aspiration prevention. Knowledge and understanding the role of Cricoid pressure involves understanding of different anatomical relationships and modes of application.
Therefore, for understanding of the topic, clearly defined research objectives must be developed. These are designed to inform the reader what the entire project is about. They also provide information and a framework based on the goals of the researcher, as well as anticipated long-term outcomes (Aims and Objectives). Clearly defined and well-developed research objectives assist in designing the scope of the study. This allows information to be explored in relation to the topic and to explain the exact steps to be utilized within the course of the study and to answer the research question(s). This requires specificity in order to meet all needs relating to the study. As a result, research objectives must be concise, clearly stating what the researcher intends to accomplish within the study. This promotes clarity for all parties. Thus, the research objectives include:
1. Determine the process used for cricoid cartilage pressure as it relates to preventing aspiration during general anaesthesia
2. Determine the reasons why this technique is considered as not good as it seems to be. Determine the pros and cons of using cricoid cartilage pressure as a method to preventing aspiration during general anaesthesia.
3. Determine alternative methods and investigate if they are safer then Cricoid Pressure.
3.3 Principal Research Question

How efficient is the use of cricoid cartilage pressure to prevent aspiration during general anaesthesia?

3.4 Methodology
(500 words maximum)
The methodology for this study involves a review of the available literature on the topic of aspiration as the result of general anaesthesia. Thus, a literature review is an evaluation report in the literature that is commonly bounded with the stated information. It provides every aspect of theory and meant for helping the author to determine the main idea of our research. All the information will be easily to read, evaluated of analysed. The information will be found from medical databases and journal databases, such as EBSCO Host, Cochrane Library, and PubMed. These specific sources were chosen due to their reputation for peer reviewed and scholarly references. Furthermore, Cochrane Library and PubMed are reputed to be two of the best medical databases available for research purposes.
The searches will involve specific key terms, which describe the limitations, inclusion criteria, and exclusion criteria. Significantly, “inclusion criteria are characteristics that the prospective subjects must have if they are to be included in the study. For our study, about Cricoid Pressure, the characteristics that can be included are the symptoms or another negative affect, which causes problems with medications prior putting the person under general anaesthesia. It may be allergic reaction to different drugs. Exclusion criteria are those characteristics that disqualify prospective subjects from inclusion in the study. Allergies to drugs or other bad side effects, which are not related with Cricoid Pressure and may not affect patient health or behaviour during operation can be transferred to exclusion criteria. Inclusion and exclusion criteria may include factors such as age, gender, race, ethnicity, type and stage of disease, the subject’s previous treatment history, and the presence or absence (as in the case of the “healthy” or “control” subject) of other medical, psychosocial, or emotional conditions. Healthy, or control, subjects may be defined as those individuals who are free of certain specified attributes of non-health” (Yale University, 2014).
It is believed that through the use of the studies and articles found through these searches, the researcher will be able to locate qualitative and quantitative information that will lead to comprehensive conclusions regarding the efficiency of cricoid pressure efficiency. The inclusion of results will be based on the hierarchy of evidence based medicine. The hierarchy of evidence based medicine is: systematic reviews, randomized controlled trials, cohort studies, case-control studies, case series and/or reports, and editorials or expert opinions (Erbe, Keiko Agena, Stewart, & Kelly, 2014). The keywords to be used are: “Anesthesia” OR “Anaesthesia” AND “Cricoid pressure” AND “Aspiration” AND “Caesarean section.” These key words are being used to allow for the alternative spelling of anaesthesia, as well as to encompass all parts of the research question.
3.5 Location of study and access arrangements

The research will be conducted at the library.

Has informal consent been obtained to access these facilities/participants?
Yes No (Please tick where appropriate)
Resource Implications
For resource Implications we are going to use different drugs for general anaesthesia. Different devices for breathing, blood pressure or pulse monitoring. Tube for patient windpipe in order to protect lungs.
3.7 Ethical Considerations

The literature review is based on previously completed research. Therefore, there is no direct contact with participants. This prevents the need for approval from the ethics committee. It will be assumed that the studies completed have obtained the necessary ethics approval and consent from the ethics committee and participants themselves. However, care will be taken to avoid plagiarism through proper citation and acknowledgement of original authors for all ideas directly quoted and paraphrased.

Is NHS R & D approval required? Yes No

If so which Trusts will be required to give approval?     
Is NHS Research Ethics Service approval required? Yes No
Does your research involves children and young people? Yes No
If yes, please indicate whether, or not, you have read and understood the University’s Safeguarding Children and Vulnerable Adults Policy
A copy of which can be found at: http://www.cardiff.ac.uk/racdv/ethics/guidelines/FINAL%20Safeguarding%20Children%20&%20VAs%20Policy%202010.doc

Yes- I have read and understand the Policy

No – I have not read or understood the Policy
(tick where appropriate)

Project Milestones and Timescales

In this section please provide a timetable for the project some of the key milestones could be the literature review, the pilot study, data collection, data processing, data analysis, the discussion, for students compilation and binding of resultant dissertation/thesis, submission, and dissemination of results.

References

Patterson, B. Patrick, A. Parker, R. (2010). The choice of ethical and legal change challenges, Rehabilitation Counseling Bulletin.43, 3-208
Mosby's Medical Dictionary. (2014). Cricoid Pressure. Retrieved from All Free Dictionary: http://medical-dictionary.thefreedictionary.com/cricoid+pressure
RMIT University. (2014). Literature Review. Retrieved from RMIT University Library: http://www.rmit.edu.au/library/literaturereview
Vanner, R. Cricoid pressure. (2009).International Journal of Obstetric Anesthesia.18 (2), 103-105.
Yale University. (2014). General Guidance Protocol Design -- Inclusion and Exclusion Criteria. Retrieved from Yale University: http://learn.yale.edu/hsp/module_5/3a_guidance.asp
Medical News Today, 2013. What is general anesthesia? [Online]. Available at: http://www.medicalnewstoday.com/articles/265592.php [Accessed: 24 January 2015].
Nursingtimes.net, 2006. Cricoid pressure. [Online]. Available at: http://www.nursingtimes.net/nursing-practice/specialisms/respiratory/cricoid-pressure/201259.article [Accessed: 24 January 2015].
Adhikary, S. and B. S, K. 2006. THE CRICOID PRESSURE. 1st ed. Indian Medical Journals. Available at: http://medind.nic.in/iad/t06/i1/iadt06i1p12.pdf
Thecochranelibrary.com, 2015. Home - The Cochrane Library [Online]. Available at: http://www.thecochranelibrary.com/view/0/index.html [Accessed: 24 January 2015].
Ncbi.nlm.nih.gov, 2015. Home - PubMed - NCBI [Online]. Available at: http://www.ncbi.nlm.nih.gov/pubmed [Accessed: 25 January 2015].

4, Signatures

In signing this form the applicant confirms that the relevant health and safety measures, in accordance with University Policy and School requirements, have been taken into account for the proposed research.

Applicant:

Academic Supervisor:
Clinical Supervisor:
For completion by staff applicants only
Project Mentor
(where applicable)

Head of Department

Version 4 22/10/08