Cricoid pressure

Cricoid pressure, also known by the eponymous name of the Sellick manoeuvre (in American English, Sellick maneuver), is a technique used in endotracheal intubation to reduce the risk of regurgitation. The technique involves the application of pressure to the cricoid cartilage at the neck, thus occluding the esophagus which passes directly behind it.

Cricoid pressure should not be confused with the "BURP" (Backwards Upwards Rightwards Pressure) manoeuvre, which is used to improve the view of the glottis during laryngoscopy and tracheal intubation, rather than to prevent regurgitation. As the name implies, the BURP manoeuvre requires a clinician to apply pressure on the thyroid cartilage posteriorly, then cephalad (upwards) and, finally, laterally towards the patient's right.

In 1961 Brian Arthur Sellick (1918–1996), an anaesthetist, published the paper Cricoid pressure to control regurgitation of stomach contents during induction of anesthesia—preliminary communication, describing the application of cricoid pressure for the prevention of regurgitation. The technique involves the application of backward pressure on the cricoid cartilage with a force of 20-44 newtons to occlude the esophagus, preventing aspiration of gastric contents during induction of anesthesia and in resuscitation of emergency victims when intubation is delayed or not possible. Some believe that cricoid pressure in pediatric population, especially neonates, improves glottic view and aids tracheal intubation apart from its classical role in rapid sequence intubation for aspiration prophylaxis.

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