UMEM Educational Pearls

Title: Pre-term tube sizes

Posted: 4/22/2011 by Mimi Lu, MD (Emailed: 5/6/2011) (Updated: 5/6/2011)
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Continuing the theme of endotracheal tube size pearls... You get a box call for a pre-term baby delivered precipitously by mom at home and baby is blue. EMS is bagging but unable to secure a definitive airway. What size ETT do you reach for? If you try to apply the formula "uncuffed ETT = (age/4) + 4", how much smaller than size 4 can you go?

Here's a nice mneumonic about guessing pre-term "tube" sizes. Please note ETT = uncuffed endotracheal tube size.

20-25 week gestation: 2.5 ETT

25-30 week gestation: 3.0 ETT

30-35 week gestation: 3.5 ETT

35-40 week gestation: 4.0 ETT

Basically, a 25-week neonate gets a 2.5 tube, a 30-week neonate gets a 3.0 tube, etc. As always, be prepared and have an additional ETT a 1/2 size smaller readily available.

UMEM Educational Pearls

Title: Pre-term tube sizes

References