Which article is shown in the given image?

Appeared in: DSSSB 13 August 2024

Explanation

The image displays a cuffed tracheostomy tube (TT).
This is identified by its characteristic short, curved shape and the presence of a neck flange (plate) designed to secure the tube over a tracheal stoma.
The key feature confirming it is 'cuffed' is the visible inflation line connected to a pilot balloon, which is used to inflate a cuff at the distal end of the tube inside the trachea.

Option A: Endotracheal (ET) tubes are much longer as they are inserted through the mouth or nose, and they lack a neck flange. The tube in the image is short, has a flange, and also possesses a cuffing mechanism (pilot balloon).
Option B: While it has a cuff (indicated by a pilot balloon), an ET tube is significantly longer than the tube shown and does not have a neck flange for securing at a stoma.
Option D: The tube in the image clearly shows an inflation line and a pilot balloon, which are the components of the cuffing system. An uncuffed tube would lack these parts.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of artificial airways and their specific features as background academic context rather than a clinical decision trigger.
Cuffed tracheostomy tubes are essential for patients requiring positive pressure mechanical ventilation or those with a high risk of aspirating oral or gastric secretions.
A critical nursing responsibility is to monitor the cuff pressure regularly (typically keeping it between 20-30 cm H₂O) to ensure an adequate seal without causing tracheal wall ischemia, necrosis, or a tracheoesophageal fistula.
What if? If the pilot balloon feels flat or does not hold air after inflation, it indicates a cuff leak. This is an airway emergency as it compromises ventilation and aspiration protection. The nurse must immediately notify the respiratory therapist and physician and prepare for a tracheostomy tube change.

How to Approach the Question

First, examine the overall shape and length of the tube in the image. Note the short, curved design and the presence of a flat plate (flange) around the tube's neck.
Recognize that the flange is characteristic of a tracheostomy tube (TT), which is inserted through a stoma in the neck. This helps rule out endotracheal (ET) tubes.
Next, look for additional components. Identify the thin line running alongside the main tube that ends in a small balloon with a valve.
Identify this as the inflation line and pilot balloon, which indicates the presence of an inflatable cuff.
Combine these two findings: a tracheostomy tube with a cuff. This leads to the correct answer.

Concept Tested & Keywords

Concept Tested: Identification of artificial airways and their specific features.
Stem keywords: article, image
Lead-in keywords: Which

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E6 Nursing Fundamentals Taylor p. 736-738

Practise the full DSSSB 13 August 2024

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