For tracheal intubation of a child of 6 years uncuffed tracheal tube of following size would be appropriate:

Appeared in: BHU NO-2019

Explanation

The correct size for an uncuffed endotracheal tube in a child older than one year is determined by a standard age-based formula.
The formula is: Internal Diameter (mm) = (Age in years / 4) + 4.
For a 6-year-old child, the calculation is (6 / 4) + 4, which equals 1.5 + 4 = 5.5 mm.

Option B: This size is significantly too small for a 6-year-old child, which would result in a large air leak and inadequate ventilation.
Option C: This size is too large for a 6-year-old and could cause trauma to the trachea, leading to complications like edema or subglottic stenosis.
Option D: This size is too small for a 6-year-old, which would lead to an insufficient seal and ineffective ventilation.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pediatric Endotracheal Tube Sizing as background academic context rather than a clinical decision trigger.
Using the correct ET tube size is critical for patient safety. A tube that is too small can lead to air leaks and inadequate ventilation, while a tube that is too large can cause trauma to the trachea, leading to edema, ischemia, or subglottic stenosis.
Nurses assisting with intubation must prepare equipment by having the calculated tube size, as well as sizes 0.5 mm smaller and 0.5 mm larger, readily available.
What if? If a cuffed tube were used, the size would typically be 0.5 mm smaller than the uncuffed equivalent. For a 6-year-old, a 5.0 mm cuffed tube would be selected to allow for cuff inflation without excessive pressure on the tracheal wall.

How to Approach the Question

Identify the key information in the question: the patient's age (6 years) and the type of equipment (uncuffed tracheal tube).
Recognize that this is a factual recall question requiring knowledge of a specific pediatric formula.
Recall the formula for uncuffed endotracheal tube size in children older than one year: (Age in years / 4) + 4.
Substitute the child's age into the formula: (6 / 4) + 4.
Perform the calculation: 1.5 + 4 = 5.5 mm.
Compare the calculated result with the given options and select the one that matches.

Concept Tested & Keywords

Concept Tested: Pediatric Endotracheal Tube Sizing
Stem keywords: tracheal intubation, child, 6 years, uncuffed tracheal tube
Lead-in keywords: appropriate size
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 765-767

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 604-606

Practise the full BHU NO-2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.