Cervical collar makes difficult airway: a simulation study using the LEMON criteria
Objective Endotracheal intubation is extremely difficult to perform in patients wearing a cervical collar for a head and neck injury. Therefore, we analyzed actual measurements using the look externally, evaluate 3-3-2, Mallampati score, obstruction, and neck mobility (LEMON) criteria before and aft...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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The Korean Society of Emergency Medicine
2018-03-01
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| Series: | Clinical and Experimental Emergency Medicine |
| Subjects: | |
| Online Access: | http://www.ceemjournal.org/upload/pdf/ceem-16-185.pdf |
| _version_ | 1797895656741797888 |
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| author | Moonsu Yuk Woonhyung Yeo Kangeui Lee Jungin Ko Taejin Park |
| author_facet | Moonsu Yuk Woonhyung Yeo Kangeui Lee Jungin Ko Taejin Park |
| author_sort | Moonsu Yuk |
| collection | DOAJ |
| description | Objective Endotracheal intubation is extremely difficult to perform in patients wearing a cervical collar for a head and neck injury. Therefore, we analyzed actual measurements using the look externally, evaluate 3-3-2, Mallampati score, obstruction, and neck mobility (LEMON) criteria before and after cervical collar application to investigate the causes of a difficult airway. Methods This simulation study was performed in 76 healthy volunteers. We measured the mouth opening, modified Mallampati classification, and neck extension before and after cervical collar application. Results The mean inter-incisor distance significantly decreased from 4.3 to 2.6 cm (P<0.001). Fifty-seven participants classified as I and II were newly classified as III and IV according to the modified Mallampati classification after cervical collar application (16% to 91%). The angles of neck extension significantly decreased from 44° to 22° after cervical collar application (P<0.001). Before cervical collar application, our simulations predicted that 14 of 76 participants (18%) would have a difficult airway, whereas after cervical collar application, 76 of 76 (100%) were predicted to have a difficult airway. Conclusion All values for the LEMON criteria (mouth opening, modified Mallampati classification, and neck extension) worsened significantly after cervical collar application. Additionally, a difficult airway was predicted in all participants after cervical collar application. |
| first_indexed | 2024-04-10T07:30:26Z |
| format | Article |
| id | doaj.art-f0a56d96b3b243feb0e7468e929bba46 |
| institution | Directory Open Access Journal |
| issn | 2383-4625 |
| language | English |
| last_indexed | 2024-04-10T07:30:26Z |
| publishDate | 2018-03-01 |
| publisher | The Korean Society of Emergency Medicine |
| record_format | Article |
| series | Clinical and Experimental Emergency Medicine |
| spelling | doaj.art-f0a56d96b3b243feb0e7468e929bba462023-02-24T01:04:00ZengThe Korean Society of Emergency MedicineClinical and Experimental Emergency Medicine2383-46252018-03-0151222810.15441/ceem.16.185168Cervical collar makes difficult airway: a simulation study using the LEMON criteriaMoonsu Yuk0Woonhyung Yeo1Kangeui Lee2Jungin Ko3Taejin Park4 Department of Emergency Medicine, National Medical Center, Seoul, Korea Department of Emergency Medicine, National Medical Center, Seoul, Korea Department of Emergency Medicine, National Medical Center, Seoul, Korea Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea Department of Emergency Medicine, National Medical Center, Seoul, KoreaObjective Endotracheal intubation is extremely difficult to perform in patients wearing a cervical collar for a head and neck injury. Therefore, we analyzed actual measurements using the look externally, evaluate 3-3-2, Mallampati score, obstruction, and neck mobility (LEMON) criteria before and after cervical collar application to investigate the causes of a difficult airway. Methods This simulation study was performed in 76 healthy volunteers. We measured the mouth opening, modified Mallampati classification, and neck extension before and after cervical collar application. Results The mean inter-incisor distance significantly decreased from 4.3 to 2.6 cm (P<0.001). Fifty-seven participants classified as I and II were newly classified as III and IV according to the modified Mallampati classification after cervical collar application (16% to 91%). The angles of neck extension significantly decreased from 44° to 22° after cervical collar application (P<0.001). Before cervical collar application, our simulations predicted that 14 of 76 participants (18%) would have a difficult airway, whereas after cervical collar application, 76 of 76 (100%) were predicted to have a difficult airway. Conclusion All values for the LEMON criteria (mouth opening, modified Mallampati classification, and neck extension) worsened significantly after cervical collar application. Additionally, a difficult airway was predicted in all participants after cervical collar application.http://www.ceemjournal.org/upload/pdf/ceem-16-185.pdfairway managementdifficult airwaycervical collarlemon criteria |
| spellingShingle | Moonsu Yuk Woonhyung Yeo Kangeui Lee Jungin Ko Taejin Park Cervical collar makes difficult airway: a simulation study using the LEMON criteria Clinical and Experimental Emergency Medicine airway management difficult airway cervical collar lemon criteria |
| title | Cervical collar makes difficult airway: a simulation study using the LEMON criteria |
| title_full | Cervical collar makes difficult airway: a simulation study using the LEMON criteria |
| title_fullStr | Cervical collar makes difficult airway: a simulation study using the LEMON criteria |
| title_full_unstemmed | Cervical collar makes difficult airway: a simulation study using the LEMON criteria |
| title_short | Cervical collar makes difficult airway: a simulation study using the LEMON criteria |
| title_sort | cervical collar makes difficult airway a simulation study using the lemon criteria |
| topic | airway management difficult airway cervical collar lemon criteria |
| url | http://www.ceemjournal.org/upload/pdf/ceem-16-185.pdf |
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