I agree with Dr Doerschug in several important aspects. The process of placing the tube in the trachea, although important, is only a small aspect of the overall management of EEI, particularly in patients without a truly difficult airway. It should start with consideration of whether endotracheal intubation is indicated for any given patient in the first place, how to handle the unexpectedly difficult airway, and how to optimize the outcome of patients presenting with a disastrous impairment of cardiopulmonary function in the context of EEI.3 It seems to me that an anesthesiologist with formal training in critical care medicine would be extremely well positioned to manage the critical care airway, including the technical skills required to accomplish tracheal intubation. In contrast, as Dr Doerschug points out, anesthesiologists without critical care training who are called from the operating room to direct airway management in the ICU might at times be too focused on the technical aspects of EEI without keeping the big critical illness-related picture in mind. Structured environments should indeed transcend medical specialty, or put more bluntly, there should be no celebration of the professional ego in airway management; patients might have unfavorable outcomes as a result. Dr Doerschug highlights an area where not a lot of progress has been made. Nonairway-related complications of EEI, which remain unacceptably high irrespective of provider training, should be the focus of future interventions. Jaber and colleagues4 and Mayo and colleagues5 have set a promising example, but more work needs to be done in this area. Randomized trials should determine the safest algorithms to secure the airway of critically ill patients and prevent the high mortality associated with periprocedural cardiovascular collapse and profound hypoxemia.