Emerg Med J 30:163-165 doi:10.1136/emermed-2012-202190.2
  • Best Evidence Topic reports

BET 1: Cricoid pressure in emergency rapid sequence induction

Report by: John Butler, Consultant in Emergency Medicine/Critical Care

Search checked by: Ayan Sen

Institution: Manchester Royal Infirmary, Manchester, UK


A short-cut review was carried out to establish whether the application of cricoid pressure during the induction of general anaesthesia reduced the incidence of regurgitation and aspiration of gastric contents. One good quality review article, two studies and two abstracts provided the best evidence to answer the clinical question. The authors, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated (table 1). It is concluded that although there is a theoretical advantage to providing cricoid pressure during induction, there is little evidence of any benefit at this time.

Clinical scenario

You are about to perform a rapid sequence intubation on a 26-year-old man with a severe head injury. You have been told that the man has consumed a significant amount of alcohol in the past 3 h. The nurse asks you whether the application of …