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Put pressure on the cricoid pressure
  1. Patrick Schober,
  2. Lothar A Schwarte
  1. Department of Anesthesiology and Lifeliner-1 HEMS, VU University Medical Center, Amsterdam, The Netherlands
  1. Correspondence to Dr Patrick Schober, Department of Anaesthesiology and Lifeliner-1 HEMS, VU University Medical Center, De Boelelaan 1117, Amsterdam 1007MB, The Netherlands; P.Schober{at}VUmc.NL

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In medicine, certain manoeuvres are established so deeply that they are dogmatically passed on from generation to generation of physicians and rewritten in textbooks without being questioned. A particularly good example is cricoid pressure (CP), used to prevent gastric regurgitation and aspiration during rapid sequence induction and intubation (RSII). Originally described by Arthur Sellick (Sellick manoeuvre) in 1961,1 it was dogmatically applied over the decades, although literature to support its use is scarce. Its longevity is largely based on its convincingly simple, mechanistic rationale: backward force applied to the ring-shaped cricoid cartilage occludes the dorsally located oesophagus, thereby presumably preventing gastro-pharyngeal reflux. Although …

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