Cervical collar makes difficult airway: a simulation study using the LEMON criteria
Clinical and Experimental Emergency Medicine
;
(4): 22-28, 2018.
Article
in English
| WPRIM
| ID: wpr-713080
ABSTRACT
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.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Classification
/
Neck Injuries
/
Airway Management
/
Healthy Volunteers
/
Head
/
Intubation, Intratracheal
/
Mouth
/
Neck
Type of study:
Prognostic study
Limits:
Humans
Language:
English
Journal:
Clinical and Experimental Emergency Medicine
Year:
2018
Type:
Article
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