Cricoid pressure

As Krikoiddruck (Cricoiddruck) or Sellick handle is called the hand against the cricoid cartilage of the larynx applied pressure of the esophagus in the region of the upper esophageal constriction during endotracheal intubation or mask ventilation should close.

The aim of the cricoid pressure was to avoid regurgitation of gastric contents into the trachea and consequently aspiration into the lungs during the intubation maneuver. It was mainly used for induction of anesthesia in non-fasting patients, the Rapid Sequence Induction (RSI) (ileus induction).

The usefulness and effectiveness of cricoid pressure has been questioned in the more recent literature, and it may even be associated with an increase in the risk of aspiration. It is no longer used to an increasing extent. The routine use of cricoid pressure for intubation during resuscitation is not recommended. It is also recommended not to use cricoid pressure when intubating children who have not fasted.

1961 was the first description of cricoid printing by Brian Arthur Sellick (1918-1996). However, such a technique for preventing vomiting in drowning victims had already been described in Great Britain in 1774.

The BURP maneuver (Backward Upwards Rightward Pressure) is carried out in a similar way, but aims to improve the intubation conditions in difficult intubation.

Individual evidence

1. ↑ Walied Abdulla: Interdisciplinary Intensive Care Medicine. Urban & Fischer, Munich a. a. 1999, ISBN 3-437-41410-0 , p. 14.
2. ↑ D. Steinmann, HJ Priebe: Krikoiddruck. In: Anaesthesiologist. 58 (7), Jul 2009, pp. 695-707. Review. PMID 19554271 ; on this: A. Timmermann, C. Byhahn: Cricoid pressure: protective handle or established nonsense? (Editorial). In: Anaesthesiologist. 58 (7), Jul 2009, pp. 663-664. PMID 19547935 .
3. ↑ A. Gobindram, S. Clarke: cricoid pressure: should we lay off the pressure? In: Anaesthesia. 63 (11), Nov 2008, pp. 1258-1259. PMID 19032264 .
4. ↑ CD Deakin et al: European Resuscitation Council Guidelines for Resuscitation 2010 Section 4. Adult advanced life support. Resuscitation. 81 (10), Oct 2010, pp. 1305-1352. PMID 20956049 .
5. ↑ Recommended action for rapid sequence induction in childhood from the Scientific Working Group on Pediatric Anesthesia of the German Society for Anesthesiology and Intensive Care Medicine (DGAI). In: Anästh Intensivmed. 48, 2007, pp. S88-S93.
6. ↑ BA Sellick: cricoid pressure to prevent regurgitation of stomach contents during induction of anesthesia. In: The Lancet . Vol 2, 1961, pp. 404-406. PMID 13749923 .
7. ^ MR Salem, BA Sellick, JO Elam: The historical background of cricoid pressure in anesthesia and resuscitation. In: Anesth Analg. 53, 1974, pp. 230-232. PMID 4593092 .

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !