Cricoid Pressure in Rapid Sequence Induction

CA-1 · I.B.6.h II.C.4.b.5 II.D.3.g.3.a

23Sources
6Kept
1Dropped

1 · Find evidence

PubMed query

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23 candidate papers

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Same-day build

PubMed query

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2 · Teaching points

Source

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7 points

Cricoid pressure prevents the laryngeal mask from seating: ventilation was adequate in every patient without it but in only 25% with it, so release it before inserting a supraglottic airway. PMID 8896856 — not confirmed against the abstract: The sentence adds a recommendation ("release it") and mentions "supraglottic airway" which is not stated in the abstract. dropped
Across 12 randomised trials in 4,862 patients, cricoid pressure did not reduce aspiration, but it worsened first-attempt success, added nearly 7 seconds to intubation and worsened the laryngoscopic view. PMID 31685271 kept
The oesophagus already lies lateral to the cricoid in more than half of necks, and applying cricoid pressure displaces it further sideways while also compressing the airway in 81%. PMID 12826843 kept
Rapid Sequence Induction (RSI) was used in 82% of patients undergoing tracheal intubation in this cohort. PMID 38702641 kept
Current data are inadequate to mandate either continuing or abandoning cricoid pressure, and no universally accepted standard exists for the high-risk aspiration patient. PMID 31397697 kept
Applying cricoid pressure significantly decreases the success rate of initial laryngeal mask airway insertion, requiring its removal for successful placement. PMID 1467077 kept
Modern evidence suggests cricoid force does not meaningfully impair successful intubation when videolaryngoscopy is used, and where it is applied it may be improved by ultrasound localisation and a trained assistant. PMID 40923828 kept

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