Cricoid Pressure, also known as Sellick’s maneuver, is a well known technique applied during endotracheal intubation. It refers to the application digital pressure on the cricoid cartilage of the larynx, pushing it backwards resulting esophageal compression against the vertebrae with the intent of preventing passive regurgitation of gastric contents.
Historically the use of cricoid pressure during RSI in the emergency department and pre-hospital settings was a well-established practice. In this era of evidence based medicine, emergency and intensive care practitioners have begun to question its efficacy. Recently the subject has been quite controversial in the EM social media arena with some very strong opinions both “For” and “Against” cricoid pressure.
I have attempted to create a compendium of some of the most recent discussions and literature in the emergency medicine, critical care and anesthesiology arenas. Personally, I find that cricoid pressure frequently distorts the airway decreasing visualization during both direct and video laryngoscopy.
Many practitioners who no longer support the practice of cricoid pressure site that there is little to no evidence to show it’s benefit, there is some evidence that it can cause harm and the majority of current data shows a harm over benefit. I urge you to seek out the information and decide for yourself.
Here is a slide from a recent presentation from Dr.Richard Levitan
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