What is the appropriate endotracheal tube size for a 4-year-old near-drowning victim?

For a 4-year-old near-drowning victim, the appropriate endotracheal tube size is determined by the child's age and typically follows guidelines based on the internal diameter of the tube. In pediatric practice, a common method to estimate the appropriate size is to use the formula: (age in years/4) + 4, which helps determine the correct French size or the internal diameter in millimeters.

In the case of a 4-year-old, applying the formula gives us: (4/4) + 4 = 1 + 4 = 5 mm.

Choosing a 5 mm endotracheal tube for this child would provide adequate airflow while minimizing trauma to the airway. This size ensures that the tube is neither too small, which could result in inadequate ventilation, nor too large, which could cause injury or irritation to the trachea.

In scenarios such as near-drowning, where airway management is critical due to potential edema or injury from water aspiration, ensuring a properly sized tube is essential for effective ventilation and oxygenation.