Cricoid : to press or not to press – SMACCGOLD HIGHLIGHT

One thought on “Cricoid : to press or not to press – SMACCGOLD HIGHLIGHT”

1. My opinion is the same as before the leture. The current recomendation from the AHA is that cric pressure is not recomended fore “routine” use. At first this would seem like a blanket saying stating not to use it at all, but the context would say something different.

   A couple of things:

   1- The AHA does not define “routine use”. in my mind, routine use means to do someting “just because:” or “every time”. On the other hand, when you have a patient/case specific reason to do something, you certainly should do it. That is not “routine” , that is specific to the circumstances. Taking cric pressure as an example, if you go in to intubate and you can only see the posterior part of the glottic opening, you could likely benifit from some transient cric pressure. By all means, DO SOME CRIC PRESSURE! It is not “routine” at that point. when the tube is secured and cuff inflated, then let it go.

   2- When you read the complete recomendation, it states CLEARLY ” If cricoid pressure is used in special circumstances during cardiac arrest, the pressure should be adjusted, relaxed, or released if it impedes ventilation or advanced airway placement.” It amazes me the numberof AHA insytructors who have not read the complete recomendations, only the protocol posters and what they heard around the beer pong table, and pass it on as gospel.

   3. The level of evidence in this recomendationis “C”, as in “Consensus opinion of experts”, single case studies, etc. There are no definitive studies for or against it. Admittedly there probably will never be any better evidence than this, there are simply more important things to research. This alone leaves a lot of wiggle room in my opinion.

   Happy Cric Pressure-ing!

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