Acute upper airway obstruction
DefinitionAn acute upper airway obstruction is a blockage of the upper airway, which can be in the trachea, voice box (laryngeal), or throat (pharyngeal) areas.
Alternative NamesAirway obstruction - acute upper
Causes, incidence, and risk factorsCauses of acute upper airway obstruction include:Allergic reactions in which the trachea or throat swell closed, including allergic reactions to a bee sting, peanuts, antibiotics (penicillin), and blood pressure medications (ACE inhibitors)Chemical burns and reactionsCroupEpiglottitis (infection of the structure separating the trachea from the esophagus)Fire or burns from breathing in smokeForeign bodies -- such as peanuts and other breathed-in foods, pieces of a balloon, buttons, coins, and small toysViral or bacteria infectionsPeritonsillar abscessRetropharyngeal abscessThroat cancerTracheomalaciaTraumaVocal cord problems
SymptomsSymptoms vary depending on the cause, but some symptoms are common to all types of airway blockage. They include:Agitation or fidgetingBluish color to the skin (cyanosis)Changes in consciousnessChokingConfusionDifficulty breathingGasping for airPanicUnconsciousnessWheezing, crowing, whistling, or other unusual breathing noises indicating breathing difficulty
Signs and testsPhysical examination may show:Decreased breath sounds in the lungsRapid, shallow, or slowed breathingTests are usually not necessary, but may include:BronchoscopyLaryngoscopyX-rays
TreatmentIf the person has a complete obstruction and is unable to speak or breathe, the Heimlich maneuver may be lifesaving.Treatment depends on the cause of the blockage.Objects stuck in the airway may be removed with a laryngoscope or bronchoscope.A tube may be inserted into the airway (endotracheal tube or nasotracheal tube).Sometimes an opening is made directly into the airway (tracheostomy or cricothyrotomy).
Expectations (prognosis)Prompt treatment is often successful. However, the condition is dangerous and may be fatal, even if treated.
ComplicationsInability to relieve the obstruction can cause:Brain damageBreathing failureDeath
Calling your health care providerAirway obstruction is an emergency. It is a good idea to learn how to clear an airway of a foreign body by using a method such as the Heimlich maneuver.Diseases in which airway obstruction develops over a period of hours will allow time to get to a hospital. If an acute airway obstruction occurs, call 911 or your local emergency number for medical help. Do what you can to maintain breathing until medical help arrives.
PreventionPrevention depends on the cause of the upper airway obstruction.The following methods may help prevent an obstruction:Eat slowly and chew food completely.Don't drink too much alcohol before or while eating.Keep small objects away from young children.Make sure dentures fit properly
ReferencesManno M. Pediatric respiratory emergencies: Upper airway obstruction and infections. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 166.Thomas SH, Brown DFM. Foreign bodies. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 57.