Brian Arthur Sellick

Brian Arthur Sellick (1918-1996) 150

Brian Arthur Sellick (1918-1996) was an English anesthetist

Best known for his description of the Sellick manoeuvre (cricoid pressure) in 1961. He is also remembered for his pioneering work on hypothermia in cardiac surgery

During his career, Sellick taught both undergraduates and postgraduate and examined for both primary and Fellowship exams travelling extensively to do so including: Europe, Scotland, the Republic of Ireland, Canada, USA, Brazil, New Zealand, Australia, Egypt and Sri Lanka


Biography
  • Born on 13 June 1918 in Dorking, Surrey, England
  • 1941 – Qualified in medicine from Middlesex Hospital
  • WWII – Worked as a Junior resident anesthetist in London; and Surgeon Lieutenant in the Royal Navy Volunteer reserve
  • 1946 – Returned as honorary consultant Anesthetic staff at the Middlesex Hospital, London. Specialized in thoracic anesthesia
  • 1953 – Fellow of the Faculty of Anesthetists. He worked for most of his career in the Middlesex Hospital with the exception of a short stint in Henry Swan’s clinic in Denver, Colorado in 1956 to observe the use of hypothermia. He introduced this technique back home after much experimentation and modification
  • 1956 – Sellick published his paper in the Lancet on the use of hypothermia in cardiac surgery.
  • 1961 – Lancet article on cricoid pressure
  • 1962 – Elected the board of the Faculty of Anesthetists, a position he held until 1978.
  • 1972-1974 Council member of the Royal College of Surgeons
  • Hickman Medal of the Royal Society of Medicine
  • Retired in 1978
  • Died 13 July 1996

Medical Eponyms
Sellick manoeuvre (1961) Cricoid pressure

The regurgitation and possible inhalation of gastric contents before intubation had been a growing problem following the use of the short acting relaxant drugs to aid intubation. Using cadavers Sellick found that he could prevent the reflux of gastric contents into the pharynx during tracheal intubation by the application of cricoid pressure

Sellick Manoeuvre for applying Cricoid Pressure Lancet 1961
Sellick Manoeuvre for applying Cricoid Pressure Lancet 1961

When the contents of the stomach or oesophagus gain access to the air-passages during anaesthesia, the consequences are disastrous. In spite of modem anaesthetic techniques – or sometimes, regrettably, because of them – regurgitation is still a considerable hazard during the induction of anaesthesia, particularly for operative obstetrics and emergency general surgery.

Cricoid pressure must be exerted by an assistant. Before induction, the cricoid is palpated and lightly held between the thumb and second finger; as anaesthesia begins, pressure is exerted on the cricoid cartilage mainly by the index finger. Even a conscious patient can tolerate moderate pressure without discomfort but as soon as consciousness is lost, firm pressure can be applied without obstruction of the patient’s airway. Pressure is maintained until intubation and inflation of the cuff of the endotracheal tube is complete

Backward pressure of the cricoid cartilage against the cervical vertebrx can be used to occlude the oesophagus (a) to control regurgitation of stomach or oesophageal contents during induction of anaesthesia, or (b) to prevent gastric distension from positive-pressure ventilation applied by facepiece or mouth-to-mouth respiration. It is contraindicated during active vomiting.

Sellick 1961

Controversies

The principal and anatomical rationale for the Sellick Manoeuvre was first described by John Hunter in 1776 in his article ‘Proposals for the recovery of people apparently drowned’. Others working in the field referenced Hunters work such as Charles Kite (1768-1811) in his essay on the recovery of the apparently dead…and the subsequent description of the construction and uses of a portable apparatus for the recovery of the apparently dead

Sellick made no reference to these other works and it is unclear whether his own maneuver was inspired by the work of Hunter, Kite and the Royal Humane Society….


Major Publications

References

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the person behind the name

Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and informatics. Asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | vocortex |

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