Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A tracheostomy is in place . The endogastric tube courses inferiorly out of the field of view . There is noted to be a left - sided chest tube in place . Widespread subcutaneous emphysema is seen throughout practically all the visualized soft tissues . The heart size is large , but stable . The mediastinal and hilar contours are unchanged . A right - sided central venous catheter tip is seen at the lower SVC . The overlying soft tissue emphysema limits assessment of the lung consolidations . There is no large pleural effusion or pneumothorax .
    OUTPUT:
    
Lines and tubes in place ; extensive subcutaneous emphysema .