TY - JOUR T1 - Rebuttal to Con JF - Respiratory Care SP - 618 LP - 619 DO - 10.4187/respcare.09914 VL - 67 IS - 5 AU - Gabrielle A White-Dzuro AU - Lauren E Gibson AU - Lorenzo Berra AU - Edward A Bittner AU - Marvin G Chang Y1 - 2022/05/01 UR - http://rc.rcjournal.com/content/67/5/618.abstract N2 - We would like to thank Drs Li and McMullan for their thoughtful response on the use of prehospital ultrasound for endotracheal tube confirmation.1We agree that the frequency of prehospital endotracheal intubation is decreasing, and with an increasing paramedic workforce, there are fewer opportunities for emergency medical services (EMS) providers to acquire hands-on intubation experience. That being said, this reduced experience emphasizes the even greater importance on post-intubation techniques for confirmation of endotracheal tube position.Whereas Drs Li and McMullan suggest that esophageal intubation has become exceedingly rare after the incorporation of capnography, frequencies as high as 5.5% in prehospital situations continue to be reported.2 For what we should consider a “never-event,” 5.5% is unacceptably high despite the ready availability of capnography in hospital and prehospital settings. Clearly, additional confirmatory strategies are needed to prevent these “never-events” from recurring.Whereas we agree with … Correspondence: Marvin G Chang MD PhD, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts 02114. E-mail: mgchang{at}mgh.harvard.edu ER -