AIIMS Delhi NO - 2018
Medical Surgical Nursing
Easy
Identify the marked item in the procedural picture below?
Appeared in: AIIMS Delhi NO - 2018
Explanation
- The image shows an Endotracheal (ET) tube, a device used to secure a patient's airway for mechanical ventilation or during anesthesia.
- The arrow points to the inflatable cuff, which, when filled with air, seals the trachea to prevent air leaks and aspiration of gastric contents.
- Visible features confirming its identity include the size marking ('I.D. 7.5'), the pilot balloon for cuff inflation, and the standard 15 mm connector for attaching to a ventilator circuit.
Why Other Options Were Wrong
- Option A: A feeding tube (like a Ryles tube or nasogastric tube) is used for enteral nutrition, not airway management. It is typically thinner, more flexible, and lacks the inflatable cuff seen in the image.
- Option B: A closed suction catheter is a device used to clear secretions from within an existing artificial airway, such as an ET tube. It consists of a thin catheter housed inside a sterile plastic sleeve and is not the primary airway tube itself.
- Option D: A hand-held manometer is a separate measurement tool, not an airway device. It has a dial or digital display and is used to check the pressure of the air inside the ET tube's cuff to prevent tracheal injury.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of airway management equipment as background academic context rather than a clinical decision trigger.
- Nurses are responsible for the comprehensive care of patients with ET tubes. This includes assessing for correct placement via bilateral breath sounds and chest x-ray confirmation, securing the tube to prevent dislodgement, and performing regular oral care to prevent Ventilator-Associated Pneumonia (VAP).
- Monitoring cuff pressure is a critical nursing intervention. The recommended pressure is 20-30 cm H₂O (or 20-25 mmHg) to create an adequate seal without compromising tracheal blood flow.
- What if? If the cuff pressure is too low (less than 20 cm H₂O), it can lead to a fluid leak around the cuff, increasing the risk of aspiration pneumonia. The nurse must re-inflate the cuff to the appropriate pressure and assess for the cause of the leak.
How to Approach the Question
- This is an image-based identification question, requiring visual recognition of medical equipment.
- First, carefully observe the object in the image. Note its distinct features: it is a curved tube with an inflatable balloon (cuff) at the end, a smaller pilot balloon on the side, and measurement markings.
- Next, read the options provided and mentally compare the definition of each item to the visual evidence.
- A 'Feeding tube' is for nutrition and lacks a cuff. A 'Closed suction catheter' is for clearing secretions and looks different. A 'Hand held manometer' is a pressure gauge.
- The features seen in the image—cuff, pilot balloon, size markings—are all characteristic of an Endotracheal (ET) Tube.
- Therefore, select the option that correctly names the device.
Concept Tested & Keywords
- Concept Tested: Identification of airway management equipment
- Stem keywords: Identify, marked item, procedural picture
- Lead-in keywords: BEST, MOST RELEVANT CLUE
- Clinical cues: Image of a cuffed tube with markings 'I.D. 7.5'
Question ID
QzhQwOCM-SJuhN4zcz1NpP
Reference Book
E6 Nursing Fundamentals Taylor pp. 734-736, 736-738
Practise the full AIIMS Delhi NO - 2018
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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