Figure 1

Endotracheal intubation in the out-of-hospital setting. In the early years of out-of-hospital emergency medical services (EMS) systems, advanced life support personnel were not only trained in the nuances of how to avoid overzealous ventilation and properly place an endotracheal tube in very challenging circumstances, but they were also well-supervised on-scene by expert physicians who themselves were highly-experienced and exceptionally familiar with those challenges as well as methods to overcome them (photo by Dr. Paul Pepe).