Cricoid Pressure

We’ve heard a lot about advanced airway management recently, with some really significant publications over the last few months and in the last few weeks in JAMA we’ve had another!

Cricoid pressure during emergency anaesthesia and for those at high risk of aspiration has been common place for more than half a century. But it’s a topic that has caused quite some debate. On one hand it has the potential to reduce aspiration, a very real and potentially very serious complication of RSI. But on the other it has the potential to hinder the view on laryngoscopy and decrease first pass success.

The founding evidence for cricoid pressure has always been a little soft. In this podcast we look at the background of cricoid pressure and then run through this key paper, discussing the implications it holds for both pre and in-hospital advanced airway management.

As always we’d love to hear any thoughts or comments you have on the website and via twitter, we look forward to hearing from you.


SimonRob & James


Effect of Cricoid Pressure Compared With a Sham Procedure in the Rapid Sequence Induction of Anesthesia: The IRIS Randomized Clinical Trial. Birenbaum A. JAMA Surg. 2018

Cricoid pressure to control regurgitation of stomach contents during induction of anaesthesia. Sellick BA Lancet. 1961

Safer Prehospital Anaesthesia 2017; AAGBI

Effectiveness and risks of cricoid pressure during rapid sequence induction for endotracheal intubation. Cochrane Database of Systematic Reviews. Catherine M Algie,2015

JC: Cricoid Pressure and RSI, do we still need it? St Emlyn’s

Cricoid: To press, or not to press? (Hinds and May)

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