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Applying cricoid pressure

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VOL: 98, ISSUE: 11, PAGE NO: 45

PHIL JEVON, RESUSCITATION OFFICER, MANOR HOSPITAL, WALSALL; JAGTAR SINGH POONI, CONSULTANT IN ANAESTHESIA AND INTENSIVE CARE, CITY HOSPITAL, BIRMINGHAM

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Cricoid pressure was first described by Sellick in the 1960s (Sellick, 1961). He advocated its use during the induction of anaesthesia to reduce the incidence of aspiration of gastric contents. It is sometimes referred to as the 'Sellick manoeuvre'.

Cricoid pressure was first described by Sellick in the 1960s (Sellick, 1961). He advocated its use during the induction of anaesthesia to reduce the incidence of aspiration of gastric contents. It is sometimes referred to as the 'Sellick manoeuvre'.

By occluding the lumen of the oesophagus, cricoid pressure helps to prevent gastric inflation during ventilation (particularly when a bag/valve/mask device is used), and regurgitation and aspiration of gastric contents (Simons, 1999). It can also help the anaesthetist during tracheal intubation by facilitating visualisation of the vocal cords. However, too much pressure may have the effect of distorting the airway and hindering direct visualisation and therefore the procedure (Resuscitation Council (UK), 2000).

When cricoid pressure is used in cardiopulmonary resuscitation, an extra healthcare professional will be required to perform the technique: this person will be unable to undertake any other tasks simultaneously.

Cricoid pressure is also used in general anaesthesia when the patient has a full stomach and is at risk of regurgitation and aspiration of gastric contents.

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