Huh? I learned one more abbrev 'trach' (for tracheostomy : noun  a surgical operation that creates an opening into the trachea with a tube inserted to provide a passage for air; performed when the pharynx is obstructed by edema or cancer or other causes) but did not get what the rest is about.

Perhaps, if you care to explain how a decision to do a trach is made and for what, we may be able to see what we are talking about here. ;-)

BTW, how do we say 'trach'? 'track' or 'trash'?