ArticleClinical and experimental emergency medicine2018
Cervical collar makes difficult airway: a simulation study using the LEMON criteria.
Article in Clinical and experimental emergency medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Channelled versus nonchannelled Macintosh videolaryngoscope blades in patients with a cervical collar: a randomized controlled noninferiority trial.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Trial
- Cervical spine immobilization does not interfere with nasotracheal intubation performed using GlideScope videolaryngoscopy: a randomized equivalence trial.Scientific reports · 2022Trial
- Inertial Sensor-Based Analysis of Cervical and Upper-Thoracic Motion During Extrication: SNAIDSensors (Basel, Switzerland) · 2026Article
- Cervical Collar in Adult Trauma: Evidence, Controversies, and Clinical Decision-Making.Orthopedic research and reviews · 2026Review
- Magnitude, associated factors of difficult airway, and predictive value of airway examinations among maxillofacial surgery patients at public hospitals in Southern Ethiopia: a multicentre cross-sectional study.Annals of medicine and surgery (2012) · 2024Article
- The effect of ATLS/PHTLS spinal motion restriction protocol on the incidence of spinal cord injury, a nationwide database study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Observational
- Article
- Effects of the Lubo cervical collar on airway patency in awake adults - A magnetic resonance imaging study.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2022Article
- Intubation during spinal motion restriction using the LuboAfrican journal of emergency medicine : Revue africaine de la medecine d'urgence · 2022Article
- Article
- No radiographic index predicts difficult intubation using the Optiscope™ in cervical spine surgery patients: a retrospective study.BMC anesthesiology · 2020Article
- Success Rate of Endotracheal Intubation Using Inline Stabilization with and without Cervical Hard Collar; a Comparative Study.Archives of academic emergency medicine · 2020Article
- A comparison of AIROD and conventional bougie as an intubation guide in simulated difficult airway: A prospective randomized study.Journal of anaesthesiology, clinical pharmacologyArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveEndotracheal 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.
methodsThis 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.
resultsThe 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.
conclusionAll 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.
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