Cricoid pressure
This is a method of preventing regurgitation of stomach contents into the larynx during intubation and induction. It is particularly indicated:
- for general anaesthesia when the patient has not fasted, or when, as a result of pain or drugs such as opiates or alcohol, gastric emptying is delayed
- in patients with a hiatus hernia
- for all emergency inductions and intubations
- in those in the late stages of pregnancy
The cricoid cartilage is manually pushed back to occlude the oesophagus. This entails:
- an assistant locating the position of the cricoid cartilage before induction
- applying firm pressure backwards with thumb and forefinger as soon as anaesthesia has been achieved
- only releasing pressure once endotracheal intubation has been confirmed
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