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2058 www.ccmjournal.org December 2018 • Volume 46 • Number 12 postextubation complaints and perform laryngoscopy to visualize potential trauma. Perhaps the most important action we can take is prevention of intubation by alternative methods (i.e., noninvasive ventilation) whenever possible and further to begin weaning immediately after intubation. Indeed, as physicians are admonished when the Hippocratic Oath is administered, our first obligation is always to “do no harm.” REFERENCES 1. Brodsky MB, Levy MJ, Jedlanek E, et al: Laryngeal Injury and Upper Airway Symptoms After Oral Endotracheal Intubation With Mechanical Ventilation During Critical Care: A Systematic Review. Crit Care Med 2018; 46:2010–2017 2. Dubick MN, Wright BD: Comparison of laryngeal pathology following long-term oral and nasal endotracheal intubations. Anesth Analg 1978; 57:663–668