Evaluating the application of cricoid pressure during rapid sequence induction and intubation
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Cricoid pressure is a widely accepted, yet highly questionable maneuver employed by airway management specialists. The function of cricoid pressure is to help prevent gastric regurgitation and pulmonary aspiration when intubating high-risk patients. Although initially well-received by the medical community, the status of cricoid pressure as a standard of care has been challenged by arguments that this procedure is ineffective, unsafe, and generally unfit for clinical practice. Moreover, the lack of a standardized protocol has contributed to significant discrepancies in the way cricoid pressure is applied. A literature analysis reveals insufficient data to determine whether or not cricoid pressure decreases the risk of regurgitation. However, the maneuver can still be deemed effective because of its anatomical basis. Advanced imaging studies affirm the ability of cricoid pressure to occlude the lumen of the postcricoid hypopharynx, physically impeding passage of gastric or esophageal content through the point of compression. An evaluation of cricoid pressure protocol is done in an effort to establish a standardized set of guidelines. Although a general consensus has been reached regarding certain aspects of the maneuver, such as force and timing, further research is required to thoroughly understand its additional intricacies. In the meantime, a cautious approach to applying cricoid pressure is strongly advised.