Identify the tube in the following image:

AIIMS Delhi NO- 2019

Medical & Surgical Nursing

Easy

Appeared in: AIIMS Delhi NO- 2019

Explanation

The image shows a flexible tube with an inflatable cuff at the tip, a pilot balloon for inflation, and depth markings, which are all characteristic features of an endotracheal tube (ETT).
The primary purpose of an ETT is to secure a definitive airway for mechanical ventilation, administer oxygen, and protect the lungs from aspiration.
The 15mm universal connector at the proximal end allows it to be connected to various respiratory devices like a ventilator or an Ambu bag.
The inflatable cuff, when filled with air via the pilot balloon, creates a seal against the tracheal wall, preventing air leaks and aspiration of foreign materials.

Option A: An oropharyngeal airway (OPA) is a rigid, J-shaped device without a cuff or pilot balloon. It is placed in the mouth to keep the tongue from obstructing the airway, not inserted into the trachea.
Option C: A tracheostomy tube is shorter and more curved than an ETT. It is inserted through a surgical opening (stoma) in the neck and has a flange that sits on the skin. The device in the image is long and designed for oral or nasal insertion.
Option D: A Combi tube is a more complex, dual-lumen emergency airway device with two separate cuffs and two inflation ports. The tube in the image is a single-lumen device.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of Airway Management Devices as background academic context rather than a clinical decision trigger.
Nurses are responsible for monitoring patients with endotracheal tubes, which includes assessing for correct placement, monitoring cuff pressure to prevent tracheal injury (necrosis or fistula), providing regular oral care to prevent ventilator-associated pneumonia (VAP), and ensuring the tube is secure.
Communication is a key challenge, as intubated patients cannot speak. Nurses must establish alternative communication methods like whiteboards, picture boards, or simple yes/no questions.
Emergency equipment, including a spare ETT, a laryngoscope, and a manual resuscitation bag (Ambu bag), must be kept at the bedside in case of accidental extubation or tube malfunction.

How to Approach the Question

First, carefully examine the image provided, paying close attention to the specific features of the medical device.
Identify key components: Is it a simple or complex tube? Does it have a cuff? Is there a pilot balloon? What is its shape and length? Note the presence of any connectors or markings.
Systematically compare these observed features with the descriptions of the options provided.
Eliminate options that do not match your visual analysis. For example, an oropharyngeal airway is uncuffed and rigid, which is different from the image.
A tracheostomy tube has a neck flange, which is absent here. A Combi tube has two lumens, unlike the single lumen shown.
Select the option that perfectly matches all the identified features. The cuffed, single-lumen tube with a pilot balloon is definitively an endotracheal tube.

Concept Tested & Keywords

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E6 Nursing Fundamentals Taylor pp. 734-736, 736-738