In the LEMON airway assessment, which step comes after Look?

• A. Mallampati
• B. Evaluate
• C. Obstruction
• D. Neck mobility

Answer: (B)

In a LEMON airway assessment, you start by looking externally for obvious deformities, trauma, obesity, or facial features that might complicate airway access. After that initial look, the next step is to evaluate the airway, which means quantitatively assessing the patient’s airway geometry. This is typically done using the 3-3-2 rule: check how wide the patient can open the mouth (at least about three fingerbreadths), measure the space from the mentum to the hyoid bone (about three fingerbreadths), and assess the distance from the floor of the mouth to the laryngeal inlet (about two fingerbreadths). If these measurements are reduced, it signals a higher likelihood of a difficult intubation or ventilation, guiding you to plan accordingly.

Mallampati, Obstruction, and Neck mobility are important steps too, but they come after evaluating the basic geometry of the airway. The Evaluate step is the bridge between looking for obvious issues and performing more specific assessments, grounding your expectations about how easy or hard intubation might be.