A prospective study of 366 patients requiring intubation in the ED revealed by logistic regression analysis that the only component of the ‘LEMON’ classification* to be independently associated with difficult intubation was a thyroid-hyoid distance of less than 2 finger breadths. They conclude that Mallampati classification is not a useful tool in predicting difficult intubation in the ED and that the LEMON acrostic can be modified to “LEON.”
Determination of difficult intubation in the ED
Am J Emerg Med. 2009 Oct;27(8):905-10
*Further definition of LEMON and information on difficult airways are available in these presentation slides by Rob Vissers FACEP