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PALS Algorithm,Endotracheal Tube Size



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Endotracheal Tube Size.
Length-based resuscitation tapes are helpful and more accurate than age-based formula estimates of endotracheal tube size for children up to approximately 35 kg , even for children with short stature.

In preparation for intubation with either a cuffed or an uncuffed endotracheal tube, confirm that tubes with an internal diameter (ID) 0.5 mm smaller and 0.5 mm larger than the estimated size are available.

During intubation, if the endotracheal tube meets resistance , place a tube 0.5 mm smaller instead.

Following intubation, if there is a large glottic air leak that interferes with oxygenation or ventilation, consider replacing the tube with one that is 0.5 mm larger , or place a cuffed tube of the same size if an uncuffed tube was used originally.

Note that replacement of a functional endotracheal tube is associated with risk ; the procedure should be undertaken in an appropriate setting by experienced personnel.

If an uncuffed endotracheal tube is used for emergency intubation, it is reasonable to select a 3.5-mm ID tube for infants up to one year of age and a 4.0-mm ID tube for patients between 1 and 2 years of age .

After age 2 , uncuffed endotracheal tube size can be estimated by the following formula: Uncuffed endotracheal tube ID (mm)=4+(age/4) .

If a cuffed tube is used for emergency intubation of an infant less than 1 year of age , it is reasonable to select a 3.0 mm ID tube.

For children between 1 and 2 years of age, it is reasonable to use a cuffed endotracheal tube with an internal diameter of 3.5 mm (Class IIa, LOE B).

After age 2 it is reasonable to estimate tube size with the following formula (Class IIa, LOE B): Cuffed endotracheal tube ID (mm)=3.5+(age/4).


PALS Algorithm DOCUMENT HOME

MSCscience.com

Stepping Up To Standards Compliance

Solution ----> Medical Standards Compliance Tools





Sponsor Links

Medical Standards Compliance Science
CPR ECC Web Site

    Medical Standards Compliance Science ,Tools For Training & Implementation
   
  2010,American Heart Association ,Guidelines for CPR and Emergency Cardiovascular Care (ECC).  
2010 ILCOR International Consensus on CPR & ECC    

Tools For Training & Implementation

  • Simulators

  • E Learning

  • Paper less charts (Electronic medical records -EMR )

  • Certification Exam Preparation