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Brian Sellick y Maniobra de Sellick
Brian Sellick y Maniobra de Sellick
Resuscitation Great
Brian Sellick, Cricoid Pressure and the Sellick Manoeuvre
Peter J.F. Baskett a,∗ , Thomas F. Baskett b
a Stanton Court, Stanton St Quintin, Wiltshire, UK
b Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada
∗ Corresponding author.
E-mail address: peterbaskett@tiscali.co.uk (P.J.F. Baskett). Fig. 2. The Lancet 1961;2:404 (reproduced with permission).
0300-9572/$ – see front matter © 2004 Elsevier Ireland Ltd. All rights reserved.
doi:10.1016/j.resuscitation.2004.03.001
6 P.J.F. Baskett, T.F. Baskett / Resuscitation 61 (2004) 5–7
The problem of regurgitation of acid stomach contents be applied without obstruction of the patient’s airway.
into the lungs was particularly dramatic in obstetric anaes- Pressure is maintained until intubation and inflation of
thesia. The New York obstetrician, Curtis Mendelson, in a the cuff of the endotrachial tube is completed......During
review of all cases at the New York Lying – in Hospital cricoid pressure the lungs may be ventilated by intermit-
from 1932 to 1945 found an incidence of 1.5 per 1000 de- tent positive-pressure without risk of gastric distention.
liveries [2,3]. Acid aspiration, or Mendelson’s syndrome as
it came to be called, was a major cause of maternal death in
the middle of the 20th century [4].
The anatomical rationale for Sellick’s manoevure had pre-
viously been put forward previously by John Hunter in 1776
in his article Proposals for the recovery of people apparently
drowned [5]. The essence of Hunter’s treatment was ‘blow-
ing air into the lungs’. To ensure that air went into the lungs
and not into the stomach he proposed the following: [5].
These posts did not carry any salary until the in- “He was a happy and fulfilled man with a great sense
troduction of the National Health Service in 1948, so of humour whose ready laughter was always full of glee”
he also gave anaesthetics at the King Edward VIIth – so wrote Bill Pallister in his obituary of Brian Sellick
Hospital for Officers and at various sanatoria treat- [11].
ing the epidemic of tuberculosis that followed the war On a personal note, one of us (PB), as an aspiring car-
[11,12]. diac anaesthetist with an interest in resuscitation, remembers
Specialising initially in thoracic anaesthesia, he became Brian as a humble and gentle, yet effective, person, always
drawn into cardiac anaesthesia in its very early days. He was approachable and politely receptive to any modest (some-
impressed with the potential of hypothermia to allow a pe- times they were very modest indeed!) ideas one would have.
riod of safe cardiac arrest to permit open heart surgery for He was a big man in every sense of the word, with a warm
relatively simple procedures such as repair of atrial secun- smile that has been captured in his photograph.
dum defects and correction of pulmonary and mitral steno-
sis. The technique of surface cooling to a core temperature
of 30 ◦ C, using ether and tubocurarine, that he developed References
after a visit to Swan and his colleagues at the University
of Colorado proved to be highly effective. In his landmark [1] Sellick BA. Cricoid pressure to control regurgitation of stomach
paper, published in 1957, he reported the successful man- contents during induction of anaesthesia. Lancet 1961;2:404–6.
agement of 32 cases without loss [13]. Ultimately the team [2] Mendelson CL. The aspiration of stomach contents into the lungs
during obstetric anaesthesia. Am J Obstet Gynecol 1946;52:1–205.
at the Middlesex Hospital, using this technique, operated on [3] Baskett TF. On the Shoulders of Giants: Eponyms and Names in
over 400 patients with atrial secundum defects with only Obstetrics and Gynaecology. London RCOG Press 1996; p. 147–8.
one death [11]. [4] Report on Confidential Inquiries into Maternal Deaths in England
Brian Sellick took a very active role in the early days of and Wales 1955–7. London: H.M. Stationary Office, 1959.
academic anaesthesia at the Royal Society of Medicine and [5] Hunter J. Proposals for the recovery of people apparently drowned.
Phil Trans R Soc Lond 1776;66:412–25.
the Faculty (later to become the Royal College) of Anaes- [6] Wilkinson DJ. The development of resuscitation in the United Kin-
thetists, serving as Vice Dean there from 1972–1974. He re- dom. In: Atkinson RS, Boulton TB, editors. The History of Anes-
ceived the Henry Hill Hickman Medal of the Royal Society thesia. Pub Royal Society of Medicine Services and the Parthenon
of Medicine for his work on cricoid pressure. In the citation Publishing Company. London and New Jersey, 1989.
for that honour it was stated – . [7] Kite C. An essay on the recovery of the apparently dead. London
1788.
“It is impossible to overestimate the benefit that this dis- [8] Curry J. Popular observations on apparent death from drowning,
covery has made to the safe conduct of anaesthesia, as it hanging, suffocation etc with an account of the means to be employed
has undoubtedly saved many patients from serious post op- for their recovery. Northampton, 1792.
erative complications or death. Thirty years (now 43) years [9] Curry J. Observations on apparent death from drowning, hanging,
after its presentation, the technique is still in use world wide suffocation by noxious vapours, fainting fits, intoxication, lightning,
exposure to cold, etc. and an account of the means to be employed
and has not been superseded by any other solution [11]”. for their recovery. London, 1815.
Sellick’s great contribution was also recognized by the [10] The American Heart Association in collaboration with the Interna-
award of the Gold Medal of the Royal College of Anaes- tional Committee on Resuscitation. Guidelines for Cardiopulmonary
thetists in 1989. Resuscitation and Emergency Cardiac Care – A Consensus on Sci-
In his retirement in Devon in the southwest of England, he ence. Resuscitation 2000;46(1–3):121.
[11] Pallister WK, Brian Arthur Sellick. (Obituary) Anaesthesia
became chairman of the local conservation society, enjoyed 1996;51:1194–5.
the theatre and concerts and worked hard in his garden and [12] Maltby JR. The Sellick Manoeuvre. In: Maltby JR, editor. Notable
at woodwork. He married Florence in 1943; they had three Names in Anaesthesia. London, RSM Press 2002; p. 196–8.
sons and ten grandchildren. He died suddenly in 1996 in his [13] Sellick BA. A method of hypothermia for open-heart surgery. Lancet
woodwork workshop. 1957;1:443–6.