Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP portable semi upright view of the chest . ETT is in place with its tip located high in the trachea approximately 6 point 4 cm above the carina . Recommend advancement . Orogastric tube extends into the left upper abdomen with its tip excluded from view . Lung volumes are low limiting assessment with bronchovascular crowding in lower lung atelectasis . Difficult to exclude a component of aspiration the lower lungs . No large effusion or pneumothorax . Cardiomediastinal silhouette is grossly unremarkable . Bony structures appear intact .
    OUTPUT:
    
As above . Please advance ETT for more optimal positioning .