Which maneuver is commonly used to prevent aspiration of stomach contents into the trachea during induction?

• A. Cricoid pressure or Sellick's maneuver
• B. Jaw thrust
• C. Head tilt
• D. Cricothyroidotomy

Answer: (A)

During induction, protecting the airway from stomach contents is crucial because reflexes that prevent choking are diminished. Cricoid pressure, or Sellick's maneuver, directly occludes the esophagus by pressing the cricoid cartilage against the cervical spine, creating a seal that reduces the chance of regurgitated gastric contents entering the trachea. This approach is classically used in rapid sequence induction to lower aspiration risk when the patient is not yet protecting the airway.

The other maneuvers don’t achieve this preventive effect. A jaw thrust helps open the airway and improve ventilation but doesn’t block the esophagus. A head tilt also aids airway alignment but doesn’t prevent regurgitation. Cricothyroidotomy is a rescue airway procedure used when the airway is obstructed or cannot be secured by conventional means, not a method to prevent aspiration during induction.

Context note: cricoid pressure is applied with enough force to compress the esophagus without impeding ventilation, but in some situations it can complicate laryngoscopy or be deemed unnecessary, so clinicians reassess as needed.