Cricoid pressure in emergency department rapid sequence tracheal intubations: a risk-benefit analysis.
Cricoid pressure is considered an integral part of patient safety in rapid sequence tracheal intubation and emergency airway management. Cricoid pressure is applied to prevent the regurgitation of gastric contents into the pharynx and subsequent aspiration into the pulmonary tree. This review analyzes the published evidence supporting cricoid pressure, along with potential problems, including increased difficulty with tracheal intubation and ventilation. According to the evidence available, the universal and continuous application of cricoid pressure during emergency airway management is questioned. An awareness of the benefits and potential problems with technique allows the practitioner to better judge when cricoid pressure should be used and instances in which it should be removed.
Department of Emergency Medicine, The Townsville Hospital, Douglas, Queensland, Australia. danellis@doctors.org.uk
Daniel Y
DY
Ellis
Tim
T
Harris
David
D
Zideman
D000328:Adult; D000818:Animals; D002648:Child; D003413:Cricoid Cartilage; D004635:Emergency Medicine / Q000379:methods*; D004636:Emergency Service, Hospital; D019317:Evidence-Based Medicine / Q000379:methods; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017214:Laryngeal Masks; D011312:Pressure; D053120:Respiratory Aspiration / Q000209:etiology / Q000517:prevention & control; D018570:Risk Assessment