To Sellick or Not to Sellick?

Routine use of Sellick maneuver (posterior displacement of the cricoid cartilage to occlude the alimentary tract) during rapid sequence intubation is no longer recommended because of inadequate proof of benefit and evidence that it might make intubation or ventilation more difficult (JW Emerg Med Jun 1 2000 and JW Emerg Med Jun 29 2007). To determine whether and how the maneuver occludes the alimentary tract, researchers obtained magnetic resonance images of 24 nonsedated volunteers with and without Sellick maneuver in three head and neck positions (sniffing, head extended, neutral).

Axial images showed a reduction in diameter of the postcricoid hypopharynx from an average of 7.3 mm without the maneuver to 4.7 mm with the maneuver in each po…