Certified Pediatric Emergency Nurse (CPEN) Practice Exam

Why is a cuffed endotracheal tube generally not used for small children?

1. They have stronger airway muscles

2. They have smaller airway diameters

3. They are resistant to intubation

4. They often have multiple respiratory conditions

The correct answer is: They have smaller airway diameters

The use of a cuffed endotracheal tube in small children is generally avoided primarily due to their smaller airway diameters. In pediatric patients, the tracheal lumen is more delicate and narrower compared to adults, making the potential for airway obstruction and trauma greater when a cuff is inflated. An inflated cuff can apply pressure to the trachea, which can lead to complications such as tracheal injury, necrosis, or even complete airway obstruction. Moreover, the physiological characteristics of the child’s airways suggest that a cuffed tube is unnecessary in many cases since children often have sufficient airway resistance that allows for effective ventilation without the need for a cuff. The other aspects mentioned in the options do not directly relate to the anatomy of their airways in the same impactful way. Understanding the nuances of pediatric airway management is critical for ensuring safe and effective ventilation in this vulnerable population.