North Pole and South Pole Endotracheal Tubes
Direct Answer
The terms "north pole" and "south pole" endotracheal tubes do not appear in current medical literature or clinical guidelines. After comprehensive review of authoritative sources including the American Heart Association, American Thoracic Society, and multiple international guidelines on airway management, these terms are not recognized nomenclature for endotracheal tube types or designs.
Standard Endotracheal Tube Classifications
The established classifications for endotracheal tubes that are clinically relevant include:
Cuffed vs. Uncuffed Tubes
- Cuffed tubes are indicated for patients requiring high-pressure ventilation, nocturnal ventilation (with daytime deflation for speech), or those with chronic translaryngeal aspiration 1
- Uncuffed tubes are preferred in most pediatric circumstances to minimize tracheal injury risk 1
- High-volume/low-pressure cuffs should maintain pressures below 20 cm H₂O to preserve airway epithelium perfusion 1
Oral vs. Nasal Routes
- Orotracheal intubation is the preferred route due to lower rates of nosocomial sinusitis and ventilator-associated pneumonia 1
- Nasotracheal tubes should be placed at 26 cm (measured at naris) in women and 28 cm in men for optimal positioning 2
Tube Material Composition
- Polyvinyl chloride, silicone, or metal tubes are available, each with distinct advantages 1, 3
- Silicone tubes conform better to airway shape when standard tubes don't provide optimal fit 1
Fenestrated vs. Non-fenestrated
- Fenestrated tubes have openings to enhance translaryngeal airflow, aiding speech and secretion clearance 1, 3
- These are especially important when using speaking valves if the tube is large relative to the airway 1
Critical Positioning Guidelines
For oral endotracheal tubes, the tip should be positioned 5 ± 2 cm from the carina with head/neck in neutral position 4. Practical placement is 21 cm at the corner of the mouth for women and 23 cm for men, achieving correct positioning in 97.6% of patients 5.
Common Pitfall
Avoid confusing non-standard terminology with established tube classifications. If "north pole" and "south pole" are institution-specific terms, clarify their meaning with local protocols, as they do not correspond to any recognized international standard for endotracheal tube design or indication 1.