BURP (Backward, Upward, Rightward Pressure) manoeuvre applied to the thyroid cartilage during laryngoscopy aims to achieve which specific effect?

• A Reduce gastric regurgitation by compressing the oesophagus
• B Stabilise the cervical spine during intubation in trauma patients
• C Prevent movement of the arytenoid cartilages during intubation
• D Displace the larynx posteriorly, superiorly, and rightward to align the glottis with the line of sight from the laryngoscope blade ✓

Explanation

BURP is an external laryngeal manipulation (ELM) technique distinct from cricoid pressure. By moving the thyroid cartilage posteriorly (against the cervical spine), superiorly (toward the hyoid), and rightward, the glottis is repositioned to align with the laryngoscopist's line of sight. It improves the CL grade in up to 30% of cases with suboptimal views. It differs from Sellick's cricoid pressure, which compresses the cricoid ring to occlude the oesophagus rather than improving laryngoscopic view.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.