View source for Predicting the difficult airway

==Difficult to Bag Ventilate==
{{Difficult BVM}}

==Difficult to Intubate (LEMON)^==
*'''L'''ook externally (gestalt)
*'''E'''valuate 3-3-2 rule
*'''M'''allampati
*'''O'''bstruction
*'''N'''eck mobility

^''An airway assessment score based on criteria of the LEMON method is able to successfully stratify the risk of intubation difficulty in the emergency department.<ref>Reed, M. et al.  Can an airway assessment score predict difficulty at intubation in the emergency department? Emerg Med J. 2005 Feb; 22(2): 99–102. doi:  10.1136/emj.2003.008771</ref>''

===LOOK===
*Look at the patient externally for characteristics that are known to cause difficult laryngoscopy, intubation or ventilation<ref> Rennie LM, Dunn MJG, et al. Is the ‘LEMON’ method an easily applied emergency airway assessment tool? European Journal of Emergency Medicine 2004;11:154–7</ref>

*Trauma
*Short neck
*Micrognathia
*Prior surgery
*May also be difficult to bag
**Body mass index
**Advanced age
**Beard
**No teeth
**Snoring
**Dentures

===Evaluate 3-3-2-1===
*3 - Ideally the distance between the patient's incisor teeth should be at least 3 finger breadths
*3 - Distance between the hyoid bone and the chin should be at least 3 finger breadths
*2 - Distance between the thyroid notch and the floor of the mouth should be at least 2 finger breadths 
*1 - Lower jaw should not sublux more than 1cm

===Mallampati===
*The patient sits upright, opens mouth and protrudes tongue
*Grades are based on visibility of the uvula, posterior pharynx, hard, and soft palate

===Obstruction===
*Assess for conditions leading to airway obstruction such as [[Peritonsillar Abscess (PTA)]], trauma, or [[Epiglottitis]].

===Neck Mobility===
*Patient places chin down onto their chest and extend their neck.
*Remove the hard collar and provide manual stabilization in trauma patients.
*Poor neck mobility impacts ability to have airway access alignment.

[[File:Mallampati Score.png|thumb|Mallampati Score]]
[[File:LEMON Score.png|thumb|3-3-2 ruleDistance between patient's incisor teeth of 3 finger breadths and distance between the thyroid notch and the floor of the mouth should be at least 2 finger widths]]

==See Also==
*[[Difficult airway algorithm]]

[[Category:Procedures]]