When assessing for a difficult airway what does the LEMON acronym remind us to check?
In a study, only three factors from LEMON are associated with a difficult intubation, which are they?
- L=Look externally (facial trauma, large incisors, beard or moustache, and large tongue)
- E=Evaluate the 3-3-2 rule (incisor distance <3 fingerbreadths, hyoid/mental distance <3 fingerbreadths, thyroid-to- floor of mouth distance <2 fingerbreadths)
- M=Mallampati (Mallampati score 3)
- O=Obstruction (presence of any condition that could cause an obstructed airway)
- N=Neck mobility (limited neck mobility).
Actually relevant to difficult intubation:
1) large incisors
2) inter-incisor distance <3 fingerbreadths
3) thyroid-to-floor-of-mouth distance <2 fingerbreadths
Reed MJ et al. Can an airway assessment score predict difficulty at intubation in the emergency department? Emerg Med J 2005 Feb; 22:99-102.