"Crash induction" in patients with full stomach

The rationale of "crash induction" in patients with full stomach is reviewed. The technique does not precipitate regurgitation in normal patients having competent cardia, provided respiratory obstruction and IPPV are avoided during induction. On the other hand, in patients with incompetent cardia such as intestinal obstruction or hiatus hernia, excessive material may accumulate in the lower oesophagus. The accumulation will be suddenly released with the cricopharyngeal relaxation subsequent to "crash induction". The stomach and oesophagus should be adequately decompressed pre-operatively, and precautionary measures such as backward cricoid pressure must be taken during induction.