Abstract
1. Anatomic considerations. The Sellick manoeuvre is designed to occlude the oesophagus by application of force to the laryngeal apparatus (targeted on the cricoid).This presupposes that the oesophagus is positioned posterior to the point of force application. This may not be the case [3]. 2. Performance considerations. The proper performance of the Sellick manoeuvre is a potential point of quality failure. The controlled environment of the operating room with the presence of a highly qualified anaesthesiologist is very different than that of a front-line intubation in the intensive care unit (ICU). There is marked variation of technique in how to perform the manoeuvre and how intensivists are trained to perform it [4]. It has been reported that attempts at the Sellick manoeuvre degrade visualization of the vocal cords during intubation [2]. 3. Lack of evidence. We are not aware of any study that documents the efficacy of the Sellick manoeuvre when performed in the context of ICU-type UEI. This is reflected in regional differences in its use. It is not widely used in France [5]. In our experience, it is not commonly used by ICU teams in the USA.
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