Why is cricoid pressure no longer commonly used during intubation?

The reason cricoid pressure is no longer commonly used during intubation relates to the potential for causing laryngeal trauma and esophageal rupture. Cricoid pressure, which involves applying pressure to the cricoid cartilage to occlude the esophagus, was historically believed to prevent aspiration during rapid sequence intubation. However, studies and clinical experiences have revealed that applying cricoid pressure can alter the anatomy and hinder access to the airway.

More importantly, excessive or improperly applied pressure may lead to injury of the laryngeal structures or even rupture of the esophagus, creating significant complications that can further complicate airway management. As a result, many practitioners now prefer techniques that allow for better visualization and access to the airway without the risk of such injuries. This shift in practice reflects an evolving understanding of airway management, prioritizing both effectiveness and patient safety.