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What is the Sellick maneuver used for?

The Sellick Maneuver is performed by applying gentle pressure to the anterior neck (in a posterior direction) at the level of the Cricoid Cartilage. The Maneuver is most often used to help align the airway structures during endotracheal intubation.

What is Cricoid pressure used for?

Cricoid pressure to occlude the upper end of the oesophagus, also called the Sellick manoeuvre, may be used to decrease the risk of pulmonary aspiration of gastric contents during intubation for rapid induction of anaesthesia. Effective and safe use of the technique requires training and experience.

What is Cricoid pressure and why is it used clinically?

Cricoid pressure, also known as the Sellick manoeuvre or Sellick maneuver, is a technique used in endotracheal intubation to try to reduce the risk of regurgitation. The technique involves the application of pressure to the cricoid cartilage at the neck, thus occluding the esophagus which passes directly behind it.

How do you do cricoid pressure during intubation?

Cricoid pressure is applied by an assistant using the thumb and second finger; the first finger stabilizes the thumb and finger on the cricoid ring. Pressure is applied firmly as consciousness is lost and released only after the tracheal tube cuff has been inflated.

Can you BURP while intubated?

As we know, backward, upward, rightward pressure (BURP) maneuver is a useful skill to facilitate glottis visualization for tracheal intubation. In Yang’s study, there is no description of applying BURP during tracheal intubation in both study groups.

How does the Sellick or BURP maneuver help when intubating?

Though Sellick can lower aspiration risk by preventing regurgitation, BURP improves the ability to see the glottis during intubation. The introduction of cricoid pressure reduced the need for waking intubation, induced hyperventilation, and similar high-stress, high-risk procedures.

How effective is Cricoid pressure?

Cricoid pressure is considered to be the gold standard means of preventing aspiration of gastric content during Rapid Sequence Intubation (RSI). Its effectiveness has only been demonstrated in cadaveric studies and case reports.

When do you use Cricoid pressure?


  1. proponents advocate use of cricoid pressure to prevent passive regurgitation during rapid sequence intubation (RSI)
  2. other suggest cricoid pressure is only necessary for high risk cases, e.g. upper GI surgery, obstetric anaesthesia, patients with bowel obstruction.

What is BURP pressure?

Applying backward, upward, rightward, and posterior pressure on the larynx (i.e., displacement of the larynx in the backward and upward directions with rightward pressure on the thyroid cartilage) is called the “BURP” maneuver and has been well described by Knill.

When do you apply cricoid pressure during intubation?

– Apply cricoid pressure. Following pre-oxygenation, but prior to intravenous induction, apply a force of 10N (1kg) and following loss of consciousness increase the force to 30N (3kg) (this force should also be applied during CPR) (Fig 4).

What does BURP maneuver mean?

The BURP maneuver (backward, upward, and rightward pressure on the larynx), introduced by Knill in 1993, has been shown to improve glottic view during laryngoscopy.

What is the sniffing position?

Background: The sniffing position, a combination of flexion of the neck and extension of the head, is considered to be suitable for the performance of endotracheal intubation. To place a patient in this position, anesthesiologists usually put a pillow under a patient’s occiput.