Is cricoid pressure needed during rapid sequence induction?

Mendelson (1946) was the first to report the risk of pulmonary aspiration of gastric contents during mask anaesthesia. Fifteen years after Mendelson's publication, Sellick (1961) reported the use of cricoid pressure to prevent gastric contents entering the pharynx and subsequent aspiration into the pulmonary tree. Cricoid pressure or Sellick's manoeuvre is the application of sustained digital pressure to the cricoid cartilage of the larynx pushing it backwards and thus compressing the oesophagus between the posterior aspect of the cricoid and the body of C5–6. The cricoid cartilage is used because it forms the only complete ring of the larynx and trachea. It has traditionally been considered an integral part of patient safety in rapid sequence tracheal intubation and emergency airway management. This article explores the arguments for the use of cricoid pressure, the concerns and its potential serious disadvantages.