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Cricoid Pressure Controversies: Narrative Review
M Ramez Salem1, Arjang Khorasani, Ahed Zeidan
1From the Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, Illinois (M.R.S., A.K.); Department of Anesthesiology, University of Illinois College of Medicine, Chicago, Illinois (M.R.S., G.J.C.); and Department of Anesthesiology, Procare Riaya Hospital, Al-Khobar, Kingdom of Saudi Arabia (A.Z.).
Cricoid pressure is controversial, with risks of airway obstruction and esophageal issues. Proper force and training are crucial for effective use, but a reliable device is lacking.
Area of Science:
- Anesthesiology
- Emergency Medicine
- Critical Care
Background:
- Cricoid pressure is used to prevent aspiration during anesthesia.
- Controversies exist regarding its necessity, effectiveness, and complications.
Purpose of the Study:
- To review and resolve controversies surrounding cricoid pressure.
- To define optimal force application and training needs.
Main Methods:
- Literature synthesis of existing information on cricoid pressure.
- Analysis of effectiveness, complications, and reliability.
Main Results:
- Effective cricoid pressure requires sufficient force to occlude the esophagus without causing airway complications.
- Complications often result from incorrect force or application.
- A reliable, easy-to-use device is unavailable.
Conclusions:
- Optimal cricoid pressure use balances efficacy and safety.
- Technology-enhanced simulation training is recommended.
- Further research is needed for device development and application refinement.
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