LEMON Flashcards
What does LEMON stand for?
L: Look externally
E: Evaluate
M: Mallampati scoring
O: Obstruction
N: Neck Mobility
What is Lemon Scale Evaluation’s role?
Stratifies patients according to the risk of difficult intubation
What are the 13 things to look for in L of LEMON?
Look externally for:
1) abnormal shape of face
2) Extreme cachexia
3) Poor dentition
4) Edentulous mouth
5) Morbid Obesity
6) High arching palate
7) Short neck
8) Large front teeth
9) surgical scar indicating previous tracheostomy scar
10) narrow mouth
11) Narrow mouth
12)Face pathology
13) Neck Pathology
What is measured in the E component?
Evaluate using the 3-3-2 rule
3: Inter-incisor space should be greater than 3 fingers
3: Hyoid-mental distance greater than 3 fingers
2: Hyoid-thyroid cartilage distance should be greater than 2 fingers
What structures are observed when carrying out Mallampati scoring?
Soft palate
Uvula
Fauces
Anterior pillar
Posterior pillar
In what patient position is the Mallampati scoring done? And in what situation is it not performable?
- Sitting position
- Emergency situation
What structures can be seen in Class I Mallampati?
-soft palate
-Fauces
- Uvula
- Anterior pillar
- Posterior pillar
What structures can be seen in Class II Mallampati?
- Soft palate
- Uvula
- Fauces
What structures can be seen in Class III Mallampati?
-Soft palate
- Base of uvula
What structures can be seen in Class IV Mallampati?
Nothing.
-Soft palate is not visible
What should be looked out for in O of LEMON (4)?
- Foreign body
- Abscess
- Tumour
- Soft tissue swelling (seen in: burn victim; expanding hematoma in trauma patient)
In N of LEMON,
1) who can be assesed for it?
2) how is it assessed?
1) Alert and awake patients
2) Patient try to place chin on their chest & tilt their head as far back as they can
When does LEMON not become a favorable tool to assess a difficult airway?
Emergency intubation
