Dr Evans and colleagues have produced an important study that addresses the relative risk of PH intubation contributing to the in-hospital risk of subsequent VAP during the hospital stay of critically injured patients. Very few data are available regarding the relative benefits of PH intubation, and even less is known about its associated risk. This well-written article examines the relative risk of future VAP among patients with trauma intubated in the ED of a large urban tertiary referral center and compares such patients with those who are intubated in the field.