European journal of anaesthesiology
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Although a life-threatening complication, pulmonary aspiration of gastric contents caused by vomiting or regurgitation during induction of anaesthesia cannot be prevented. It may be prevented if the mouth is placed more inferiorly than the larynx and tracheal bifurcation by the use of head-down tilt and head-neck positioning. ⋯ A head-down tilt equal to the mouth-arytenoid angle (levelling the mouth with the larynx) was necessary to completely prevent aspiration. This angle of tilt was within clinically relevant ranges only with the Sellick position.