Article Text

Download PDFPDF

Can an airway assessment score predict difficulty at intubation in the emergency department?
  1. M J Reed1,
  2. M J G Dunn1,
  3. D W McKeown2
  1. 1Emergency Department, Royal Infirmary of Edinburgh, Edinburgh, UK
  2. 2Anaesthetic Department, Royal Infirmary of Edinburgh
  1. Correspondence to:
 Dr M J Reed
 Emergency Department, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK; mattreed1hotmail.com

Abstract

Aim: To assess whether an airway assessment score based on the LEMON method is able to predict difficulty at intubation in the emergency department.

Methods: Patients requiring endotracheal intubation in the resuscitation room of a UK teaching hospital between June 2002 and September 2003 were assessed on criteria based on the LEMON method. At laryngoscopy, the Cormack and Lehane grade was recorded. An airway assessment score was devised and assessed.

Results: 156 patients were intubated during the study period. There were 114 Cormack and Lehane grade 1 intubations, 29 grade 2 intubations, 11 grade 3 intubations, and 2 grade 4 intubations. Patients with large incisors (p<0.001), a reduced inter-incisor distance (p<0.05), or a reduced thyroid to floor of mouth distance (p<0.05) were all more likely to have a poor laryngoscopic view (grade 2, 3, or 4). Patients with a high airway assessment score were more likely to have a poor laryngoscopic view compared with those patients with a low airway assessment score (p<0.05).

Conclusions: 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. Patients with a poor laryngoscopic view (grades 2, 3, or 4) were more likely to have large incisors, a reduced inter-incisor distance, and a reduced thyroid to floor of mouth distance. They were also more likely to have a higher airway assessment score than those patients with a good laryngoscopic view.

View Full Text

Statistics from Altmetric.com

Footnotes

  • Funding: none.

  • Conflicts of interest: none declared.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Primary Survey
    Kevin Mackway-Jones