Acute upper airway obstruction

Causes and Risks:
Acute upper airway obstruction may have any of a number of causes including viral and bacterial infections, chemical burns and reactions, allergic reactions , foreign bodies, and trauma. The blockage can be complete or partial. Mild obstruction may result in air hunger while more sever obstruction can lead to cyanosis and varying states of consciousness. Complete obstruction , if not corrected, leads to rapid suffocation and death.

Symptoms of acute upper airway obstruction are dramatic an easy to diagnosis. The individual may suddenly begin having difficulty breathing or be unable to breathe at all. Cyanosis, unconsciousness and death may rapidly follow significant partial or total obstruction.

Common causes of acute upper airway obstruction include:
  • foreign bodies
    • In adults foreign bodies are usually aspirated chunks of meat or food. In children, while peanuts are the most commonly aspirated food, hot dogs are the most common fatally aspirated food. Children also aspirate or choke on many non-food items. Airway obstruction from aspirated balloon fragments, buttons, coins and small toys is common.

  • anaphylaxis
    • Acute allergic reactions in which the trachea and/or throat swell closed are common. The classical example is allergic reactions to bee stings which frequently cause anaphylactic reactions.

  • croup
    • Croup may lead to a fairly rapid decrease in airway diameter and marked respiratory distress.

  • epiglottitis
    • Acute bacterial epiglottitis can cause rapid airway obstruction as the epiglottis swells and occludes the airway

  • retropharyngeal abscess
    • A rapidly expanding abscess can block the airway and cause respiratory distress.

  • peritonsillar abscess
    • Obstruction similar to retropharyngeal abscess.

  • laryngospasm



Prevention:
Prevention is dependent on the cause of the upper airway obstruction . See the individual diseases in the above section for more information.

Symptoms:
Symptoms vary depending on the cause but some symptoms remain fairly common to all types of obstruction.



Signs and Tests:
Physical examination may show decreased breath sounds . Tests are usually not necessary, but may include a chest X-ray , bronchoscopy , or blood gas analysis.

Treatment:
Treatment depends on the cause of the blockage. Aspirated objects may be able to be removed with bronchoscopy . A tube may need to be inserted into the airway (endotracheal tube or nasotracheal tube). Sometimes an opening needs to be made directly into the airway ( tracheostomy ).

Prognosis:
Prompt treatment is often successful. However, the condition is dangerous and potentially fatal even if treated.

Complications:
Inability to relieve the obstruction causing breathing failure!

Call Your Healthcare Provider:
Airway obstruction is an extreme emergency. People should have some knowledge of procedures to clear an airway of a foreign body (such as the Heimlich maneuver ). Diseases where airway obstruction develops over a period of hours allow time to call a physician. In the advent of acute airway obstruction call 911 (or other emergency number) for medical help and use what knowledge and materials are available to maintain breathing until medical help arrives.


A cross-section illustration of the mouth, nasal cavity, and throat. The nasal passages are also visible.