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Hi Anonymous-

I'm sorry about your friend.

Not knowing all the details, I can say your friend is likely unable to get air into his lung through his mouth or nose without an endotracheal (ET) tube. There is really one reason to have a trach, and that is to breathe. Meaning without the trach, your friend would be unable to breathe. It is a much more stable way to be sure your friend can get air than having the ET, which can become dislodged or pulled out accidentally. ETs can also erode the skin in your mouth and trachea over time, making the trach much better for longer-term use.

Often rehab facilities have strict guidelines on what sort of patients they can take. The staffing is quite different than hospital staffing. In an ICU, there is someone nearby constantly and if something happens to dislodge that ET tube someone is there to react immediately. The rehab facility is for more stable patients, meaning their condition isn't likely to worsen rapidly, so the staffing is not as high. It doesn't mean you don't get good care, but it is a different kind of care. The facility probably doesn't have pulmonologists on site all the time in case there is an ET tube problem, so they likely require trachs in ventilated patients.

I hope this answered your question. Please let me know if I can clarify anything further.

April 8, 2010 - 7:14am

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