Below you can read the answer to my question (Cricoid pressure in new DAS (Difficult Airway Society) Guidelines: still on?) from Chris Frerk, Chair of DAS guidelines group:
“Mario
Thanks for your thoughtful comments
The website posting is necessarily brief and there will be more detail in the developing paper.
Your point is well made re cricoid pressure vs BURP and external laryngeal manipulation.
The paper is predominantly aimed at anaesthesia for surgery in the UK though we recognise that the existing 2004 guidelines are referred to in ED and ITU settings. Current UK practice does endorse cricoid pressure for RSI (which includes most ED intubations) though we are aware this is not the case in other countries – we’ve taken the stance so far that this paper isn’t the place to debate RSI techniques but we do have a developing section on RSI.
I think we do need to be more explicit about when cricoid pressure would be expected to be applied – we are already clear in the paper that if it is applied and laryngoscopy is difficult the pressure should be removed (with suction at hand). In the elective scenario (with no cricoid pressure) then we say BURP / external laryngeal pressure (different from cricoid pressure) should be tried to see if view improves.
The group meet again soon and we’ll be discussing your thoughts in more detail then.
Thanks for taking the time to contribute”
Chris Frerk
Chair of DAS guidelines group
Now is only a matter of time.
We wait for the release of the new DAS Guidelines on intubation and, as Chris anticipated, on RSI.
Stay tuned on MEDEST and all the FOAMED community to be up to date on this and all the news from the Emergency Medicine World
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