Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The tip of the endotracheal tube lies 1 .9 cm from the carina and can be retracted slightly . A gastric tube extends into the stomach . No focal consolidation , pleural effusion or pneumothorax identified . There are low bilateral lung volumes . The size and appearance of the cardiomediastinal silhouette is unchanged . Displaced left rib fractures are again visualized .
    OUTPUT:
    
No significant interval change since the prior radiograph . Again , in the endotracheal tube lies close to the carina and can be retracted by approximately 2 cm .