Cricoid pressure is dead (Birenbaum 2018)

A brief critical appraisal of the IRIS trial (Birenbaum 2018)

Despite being described by Sellick almost 60 years ago, there has never been any convincing evidence supporting cricoid pressure during rapid sequence intubation. (Sellick 1961) Based on physiologic reasoning, it is frequently described as being “standard of care”. However, when studied, cricoid pressure doesn’t actually seem to decrease aspiration. (Ellis 2007; Neilipovitz 2007; Fenton 2009). Worse, cricoid pressure has been shown to worsen laryngeal view during intubation, and even completely obstruct the airway. (Allman 1995; Palmer 2000; Levitan 2006; Oh 2013) The result has been a relatively classic debate in medicine between a historical “standard” and science. Unfortunately, the available science has been relatively weak, until now…

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Articles of the month (July 2018)

A monthly (ish) summary of the emergency medicine literature

You will probably notice a new format to the articles of the month. I was getting sick of not being able to find papers that I knew I had previously commented upon. Having them listed as one 10 papers in the articles of the month made them very difficult to search for. Therefore, on bigger, more important papers, I have started writing stand alone blog posts. I will still include those papers in the articles of the month, but the summary will be truncated, with a link to the blog for all the details. The articles of the month will probably still contain extra articles, including papers that don’t warrant their own post and my usual “just for fun” kind of papers. Let me know what you think. Continue reading “Articles of the month (July 2018)”