NORCET 3 - 2022 (Shift-1)
Child Health Nursing (Pediatrics)
Easy
What is the formula of un-cuffed ET size for child?
Appeared in: NORCET 3 - 2022 (Shift-1)
Explanation
- The standard formula for calculating the size of an uncuffed endotracheal (ET) tube for a child older than one year is (Age in years / 4) + 4.
- This is widely known as the Cole formula and provides an estimate of the required internal diameter of the tube in millimeters.
- This formula is a foundational piece of knowledge for pediatric emergency care and anesthesia.
- It ensures the selection of a tube that fits the child's airway without being too tight (causing injury) or too loose (causing leaks).
Why Other Options Were Wrong
- Option B: This formula uses an incorrect denominator (3.5). The standard and widely accepted denominator in the Cole formula is 4.
- Option C: This formula incorrectly uses months in the calculation. The standard pediatric ET tube sizing formula is based on the child's age in years.
- Option D: This option incorrectly labels the formula for an uncuffed tube as the formula for a cuffed tube. The formula (Age/4) + 4 is for uncuffed tubes.
Related Visual
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.
- A nurse's primary role during intubation is preparation. This includes calculating the estimated tube size and preparing the calculated size, one size smaller (0.5 mm), and one size larger (0.5 mm) to ensure the right fit is available.
- For cuffed tubes, the nurse must also prepare a 10 mL syringe to inflate the cuff and a manometer to check that the cuff pressure is maintained between 20-25 cm H2O to prevent tracheal ischemia.
- What if the child is younger than 1 year? The age-based formula is not used. For infants and neonates, ET tube size is determined by weight or gestational age (e.g., a full-term newborn >3 kg typically requires a 3.5-4.0 mm tube).
How to Approach the Question
- First, identify the key components of the question: it asks for a 'formula' for an 'un-cuffed ET size' in a 'child'.
- This is a factual recall question. Access your knowledge of standard pediatric emergency formulas.
- Recall the Cole formula for uncuffed tubes: (Age in years / 4) + 4.
- Scan the options to find the one that matches this exact formula.
- Eliminate the other options by identifying their errors: incorrect numbers (3.5), incorrect units (months), or incorrect tube type (cuffed vs. uncuffed).
Concept Tested & Keywords
- Concept Tested: Pediatric Endotracheal Tube Sizing
- Stem keywords: formula, un-cuffed ET size, child
- Lead-in keywords: What is
- Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Question ID
QxS-T8AE9KN5iepvVuIRyI
Reference Book
E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 765-767
Practise the full NORCET 3 - 2022 (Shift-1)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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