Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP single view of the chest has been obtained with patient in semi-upright position . Analysis is performed in direct comparison with the next preceding similar study dated ___ . The long semi-metallic wide - caliber tracheostomy cannula is again identified . Apparently its external portion has now been flipped over to the patient 's left side . The more central portion of the tube is overlying trachea on the frontal view still pointing somewhat to the left wall of the trachea , but not penetrating it . There is no evidence of pneumothorax and no new pulmonary parenchymal abnormalities are identified . A previously described Dobbhoff line remains in place , reaching into the stomach .
    OUTPUT:
    
Tracheostomy tube in place . External portion of the tube has changed position . Central portion of tube overlying trachea on frontal view . Single view examination can not render further detail . If difficulties with tracheostomy position have been encountered , recommend fluoroscopic examination .