Which procedure is ongoing in the image?

Appeared in: AIIMS Delhi NO - 2018

Explanation

The image clearly depicts endotracheal (ET) tube insertion.
A laryngoscope is being used to lift the tongue and epiglottis, providing a direct view of the larynx.
An ET tube is being passed through the mouth, destined for the trachea.
This combination of equipment (laryngoscope, ET tube) and technique (oral insertion for airway access) is characteristic of endotracheal intubation.

Option B: Tracheostomy tube insertion is a surgical procedure that involves creating an opening directly into the trachea through the neck, not through the mouth as shown.
Option C: Urinary catheterisation involves inserting a catheter into the bladder via the urethra to drain urine. It is unrelated to the airway or respiratory system.
Option D: Ryle's tube (nasogastric tube) insertion involves passing a tube through the nose or mouth into the stomach for feeding or gastric decompression. A laryngoscope is not typically used for this procedure.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of airway management procedures as background academic context rather than a clinical decision trigger.
Endotracheal intubation is a fundamental skill in emergency medicine, anesthesia, and critical care to manage respiratory failure and protect the airway.
Nurses play a crucial role in preparing equipment, assisting during the procedure, monitoring the patient's vital signs (oxygen saturation, heart rate, blood pressure), and confirming tube placement.
Post-intubation care includes securing the tube, providing oral hygiene, suctioning secretions, and monitoring for complications like tube displacement, obstruction, or ventilator-associated pneumonia.

How to Approach the Question

First, carefully analyze the image to identify the key actions and equipment being used.
Observe that a provider is inserting a tube into the patient's mouth.
Identify the specific instrument in the provider's left hand as a laryngoscope, which is used to visualize the airway.
Recognize the tube being inserted as an endotracheal (ET) tube.
Correlate these observations with the provided options. The use of a laryngoscope for oral tube insertion is specific to ET tube insertion.
Eliminate the other options based on their definitions: Tracheostomy is surgical (neck), catheterisation is urinary (urethra), and Ryle's tube is for the stomach (usually no laryngoscope).

Concept Tested & Keywords

QVVtNi0zaJfH3pqc86LMjA

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

E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 115-117

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