Surgical Airways

Question 1

LEMON Airway Assessment Method

Answer 1

L - Look externally
E - Evaluate the 3-3-2 rule
M - Mallampati score ≥3
O - obstruction
N - Neck mobility

Question 2

Stridor is a manifestation of obstruction in the ____

Answer 2

laryngotrachea

also:

• subcutaneous air (massive)
• hoarseness
• dysphonia
• hemoptysis

Question 3

Sucking wound is a manifestation of obstruction in the _____

Answer 3

pharyngeal and/or hypopharyngeal area

also:

• sucutaneous air
• hematemesis
• dysphagia

Question 4

remarks on tracheostomy

Answer 4

preferred in children under 12 y/o, particularly those under 8

Question 5

tube size used for emergency surgical airway

Answer 5

6-mm tracheostomy tube
5- to 6-mm endotracheal tube

Question 6

the vascular structure often injured during cricothyrotomy

Answer 6

thyroidea ima artery

Question 7

cricothyrotomy: make a ______ incision initially… then what?

Answer 7

vertical

but then make a horizontal incision on the membrane itself to avoid vascular injury

Question 8

cricothyrotomy: if using ET tube, insert no more than _____ to avoid mainstem bronchus placement

Answer 8

2-3 cm

Question 9

components of L of LEMON

Answer 9

L - Look externally
- facial trauma
- large incisors
- beard
- large tongue

Question 10

components of E of LEMON

Answer 10

E - Evaluate the 3-3-2 rule
Incisor opening distance: (inter-incisor distance)
should be at least 3 fingerbreadths
Hyoid-mental distance: ≥3 fingerbreadths
Thyroid-to-mouth distance (from thyroid notch to floor of the mouth): ≥2 fingerbreadths

Question 11

components of M of LEMON

Answer 11

Mallampati score ≥3 suggests difficult intubaiotn
Class 3: only soft palate, base of uvula are visible
Class 4: hard palate only

Question 12

components of O of LEMON

Answer 12

O - Obstruction
Blood and vomitus
Food and dentition
Trauma and fractures
Mass or abscess
Stenosis and epiglottitis

Question 13

components of N of LEMON

Answer 13

N - **Neck mobility*
(limited neck mobility)