When life gives you L.E.M.O.N.’s, Let’s Intubate!!
When life gives you L.E.M.O.N.’s, let’s intubate!! While this may not be the most traditional use of lemons, as a medical professional, I can think of no better way to put them to use. L.E.M.O.N. is an acronym that stands for: Look at the patient, Evaluate the patient, Mallipati score, Obstruction (internal or external), and Neck (size and mobility). This acronym is sometimes used by medical professionals when preparing to intubate a patient – and trust me, it comes in handy! Endotracheal intubations can be a complicated and high-stress procedure, but following the L.E.M.O.N. technique will help just a bit more to help make sure everything goes smoothly. So next time you’re faced with a bunch of lemons, don’t get sour – just remember: let’s intubate!!
LOOK at your patient.
Look at your patient – a prodigious task if we do say so ourselves. After all, as the trustworthy L in L.E.M.O.N., it’s your responsibility to size up and evaluate the situation – from facial trauma to beards to their overall consciousness level – with a single glance! It may sound simple, but trust us when we say that Look is the crucial first step for a successful intubation procedure. Take it from us: Look before you leap, at least in this context!
EVALUATE your patient’s mouth
Evaluating a patient’s mouth and the airway is a crucial step before intubating– fortunately, there are some tricks to help get the job done. The 3-finger rule, for example, is an easy way to measure the size of a patient’s mouth open and the distance of their trachea to their chin. This lets you determine which laryngoscope size you must use, as well as any potential difficulties in terms of angle or view during the procedure. With enough practice, you could even become an Intubation Master! Evaluate your patients’ airways wisely; it’s key to being successful when intubating.
There are many other techniques you can use to help evaluate patients airway’s on your way to becoming an Intubation Master!
What’s the Mallipati score?
When thinking about the intubation process, one of the most important things you should keep in mind is Mallipati. That’s because Mallipati scores are a great indicator of the level of difficulty one may experience during the intubation for a given patient. Essentially, Mallipati scores tell you what kind of shape the person’s mouth and throat are in regards to the ability to visualize their airway during the procedure, which can make all the difference during intubation. So don’t forget that when it comes to L.E.M.O.N., M is definitely for Mallipati!
OOOO!!…Obstruction
OOOOO!! O is for Obstruction, which – typically when it comes to medical situations – no one wants to hear. That’s exactly why the acronym L.E.M.O.N. is so helpful in this medical setting! It can be anything from food or secretions to teeth or other objects that may present an issue once the procedure has begun. It provides simple instructions that help providers deal with obstruction issues before they arise and make sure the patient’s airway stays open, so life-saving treatments remain a possibility.
Got no Neck!
Neck examinations can be crucial when it comes to successful intubations. Neck length and the presence of a C-collar are especially important to keep in mind when it comes to ensuring that your patient is properly attended to. Of course, there are occasions where examining the neck isn’t so straightforward — if the patient has shorter than normal neck due, swollen or inflamed due to a traumatic episode, or even if they’re wrapped in a C-collar for extra support — it’s essential for medical professionals to think on their feet. Either using video laryngoscopy or having someone hold a patient’s C-spine straight are vital options to have on standby before intubating the patient. A simple look to check on the condition of the neck might just be one small part of LEMON, but it packs a big punch!
It’s essential to have safe and efficient intubations every time. This is where following the L.E.M.O.N. acronym can be of great help to ensure success in the procedure. Having this simple phrase as a mnemonic is handy and with practice, second nature to healthcare workers in performing intubations as quickly and safely as possible. Ask yourself – has my team used LEMON? And if you have, reflect on how it was easy or not so much for you and/or your team to use LEMON for better intubating results! Understanding the crucial steps involved in the preparation, evaluation, and understanding of the patient’s anatomy is paramount in successful intubation procedures – so remember, just add a LEMON to make a successful tart!
We hope this blog post helped you gain some insight into the proper intubation procedure and that it gave you that extra pucker of success the next time you walk into a patient’s room! Let us know what you think and anything you think we are missing so we can keep improving our workflow process for medical professionals everywhere.
