Questions · Cricoid Pressure in Rapid Sequence Induction
9 questions, 0 approved. Approve them one at a time — a quiz shows nothing you have not.
Recall — derived from a kept point
An MRI study examined the position of the oesophagus relative to the cricoid and the effect of applying cricoid pressure. Where does the oesophagus lie in most necks at baseline, what does cricoid pressure do to its position, and what happens to the airway?
Answer: The oesophagus already lies lateral to the cricoid in more than half of necks. Applying cricoid pressure displaces it further sideways, and it also compresses the airway in 81% of subjects.
The anatomy is not on the side of the manoeuvre — in most necks you are pushing a laterally placed oesophagus further aside while narrowing the airway.
Source claim: 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%.
Cricoid Pressure Displaces the Esophagus: An Observational Study Using Magnetic Resonance Imaging, Anesthesiology 2003
recall · CA-1 · phrased by llm
Pooled randomised trials of cricoid pressure during intubation found no reduction in aspiration. Describe the intubation-related harms found in that same pooled analysis, so you can state what you are giving up when you apply it.
Answer: Across 12 randomised trials in 4,862 patients, cricoid pressure did not reduce aspiration, and it worsened first-attempt success, added nearly 7 seconds to intubation and worsened the laryngoscopic view.
If the manoeuvre does not reduce aspiration but costs you the view, the first attempt and seven seconds, the trade is going the wrong way.
Source claim: 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.
Cricoid Pressure During Intubation: A Systematic Review and Meta-Analysis of Randomised Controlled Trials, Heart & lung : the journal of critical care 2020
recall · CA-2 · phrased by llm
You have decided to use cricoid force during a rapid sequence induction performed with a videolaryngoscope. Based on modern evidence, what effect should you expect on your ability to intubate, and what two things can improve how the force is applied?
Answer: Modern evidence suggests cricoid force does not meaningfully impair successful intubation when videolaryngoscopy is used. Where it is applied, it may be improved by ultrasound localisation and by a trained assistant.
If you are going to apply cricoid force, the videolaryngoscope blunts the cost, and who applies it and where matters more than whether you apply it.
Source claim: 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.
Cricoid Force: Anatomic, Physiologic, and Clinical Concepts, Anesthesiology 2025
recall · CA-2 · phrased by llm
A resident asks you to give a definitive answer on whether cricoid pressure should be used in the patient at high risk of aspiration. Explain what the current state of the evidence permits you to say, and why you cannot give a categorical answer either way.
Answer: Current data are inadequate to mandate either continuing or abandoning cricoid pressure, and no universally accepted standard exists for the high-risk aspiration patient. The evidence does not support a categorical instruction in either direction, so the honest answer is that this remains a matter of local practice and individual judgement rather than a settled standard.
Being able to say the evidence does not settle this is a better answer than confidently picking a side that the data cannot support.
Source claim: Current data are inadequate to mandate either continuing or abandoning cricoid pressure, and no universally accepted standard exists for the high-risk aspiration patient.
The Clinical Use of Cricoid Pressure: First, Do No Harm, Anesthesia and analgesia 2021
recall · CA-3 · phrased by llm
Rapid Sequence Induction (RSI) was used in ___% of patients undergoing tracheal intubation in this cohort.
Answer: 82
Rapid Sequence Induction (RSI) was used in 82% of patients undergoing tracheal intubation in this cohort.
Airway Management and Pulmonary Aspiration During Surgical Interventions in Pregnant Women in the 2nd/3rd Trimester and Immediate Postpartum - A Retrospective Study in a Tertiary Care University Hospital · PMID 38702641
recall · CA-1 · phrased by derived
The point with one number taken out. No model wrote any of this: the stem is the sentence you reviewed, minus a digit, and the paper it came from is named beneath it.
Open prompts
Walk me through your setup for this before we start.
open · CA-1 · phrased by derived
What are you watching on the monitor that would tell you this is going wrong?
open · CA-1 · phrased by derived
What is your first move if it does?
open · CA-1 · phrased by derived
What would you want ready in the room before induction?
open · CA-1 · phrased by derived
Questions only — nothing here asserts anything, which is why a model is allowed to phrase them. Where no model was reachable these are the level defaults.