A nurse is assessing an endotracheal tube and needs to press the cricoid. This technique is known as:

NORCET 7 Prelims -2024

Medical Surgical Nursing

Easy

Appeared in: NORCET 7 Prelims -2024

Explanation

The Sellick maneuver is the specific medical term for applying firm, backward pressure on the cricoid cartilage.
Its primary purpose is to compress the esophagus against the underlying cervical vertebrae.
This action is intended to prevent the passive regurgitation of gastric contents into the pharynx and subsequent aspiration into the lungs during endotracheal intubation.
It is a key component of rapid sequence intubation (RSI), a procedure used for patients at high risk of aspiration.

Option B: The Valsalva maneuver involves forced expiration against a closed glottis (bearing down), which increases intrathoracic pressure. It is unrelated to applying external pressure to the neck.
Option C: The Trendelenburg position is a specific patient posture where the head is tilted down and the feet are elevated. It is a positioning technique, not a manual maneuver applied to the neck.
Option D: The Heimlich maneuver consists of abdominal thrusts to expel a foreign object from the airway of a choking victim. It targets the diaphragm to create forceful exhalation, not the cricoid cartilage.

Visual 1: Diagram - A sagittal view of the neck anatomy illustrating the application of cricoid pressure. The visual should clearly show the finger pressing on the cricoid cartilage, the esophagus being compressed against the cervical spine, and the trachea remaining open for intubation.

Clinical Relevance

Nursing practice connection: Knowing Identification of the Sellick maneuver (cricoid pressure) during airway management helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Correct application of the Sellick maneuver is a critical nursing skill during rapid sequence intubation to enhance patient safety by reducing aspiration risk.
Nurses assisting with intubation must be able to locate the correct landmark (the cricoid cartilage, which is a complete ring below the thyroid cartilage) and apply firm, consistent pressure until the endotracheal tube cuff is inflated and placement is confirmed.
The routine use of the Sellick maneuver is debated, and institutional protocols may vary. It is crucial to follow the specific guidelines of the facility and the instructions of the provider performing the intubation.

How to Approach the Question

First, identify the key action described in the question stem: 'press the cricoid'.
Second, recognize the clinical context: 'assessing an endotracheal tube', which points to an advanced airway management procedure.
Third, recall the specific medical terminology for maneuvers related to airway and resuscitation.
Fourth, evaluate each option against the action of 'pressing the cricoid'. The term 'Sellick maneuver' is the direct definition of this action.
Finally, eliminate the other options by identifying their correct, and different, purposes (Valsalva for pressure equalization, Trendelenburg for positioning, Heimlich for choking).

Concept Tested & Keywords

Concept Tested: Identification of the Sellick maneuver (cricoid pressure) during airway management.
Stem keywords: endotracheal tube, press the cricoid
Lead-in keywords: known as

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