Open AccessRapid-sequence intubation and cricoid pressure
Author(s) -
Joshua C Stewart,
Sanjay M. Bhananker,
Ramesh Ramaiah
Publication year - 2014
Publication title -
international journal of critical illness and injury science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.274
H-Index - 12
eISSN - 2231-5004
pISSN - 2229-5151
DOI - 10.4103/2229-5151.128012
Subject(s) - cricoid pressure , medicine , rapid sequence induction , intubation , anesthesia , airway , airway management , pulmonary aspiration , intensive care medicine
Airway management is the most important clinical skill for anesthesiologist, emergency physician, and other providers who are involved in oxygenation and ventilation of the lungs. Rapid-sequence intubation is the preferred method to secure airway in patients who are at risk for aspiration because it results in rapid unconsciousness (induction) and neuromuscular blockade (paralysis). Application of cricoid pressure (CP) for patients undergoing rapid-sequence intubation is controversial. Multiple specialty societies have recommended that CP is not effective in preventing aspiration; rather it may worsen laryngoscopic view and impair bag-valve mask ventilation. Some experts think that CP should be applied in trauma and patients at risk for aspiration; however CP, if necessary, should be altered or removed to facilitate intubation.