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Acute upper airway obstruction
Alternative namesAirway obstruction - acute upper; Choking
An acute upper airway obstruction is a blockage of the upper airway, which can be in the trachea, laryngeal (voice box), or pharyngeal (throat) areas.
Causes, incidence, and risk factors
Acute upper airway obstruction may have any of a number of causes including viral and bacterial infections, fire or inhalation burns, 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 severe obstruction can lead to cyanosis and confusion or unconsciousness. Complete obstruction, if not corrected, leads to rapid suffocation and death.
Symptoms of acute upper airway obstruction are dramatic and easy to diagnose. 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:
Symptoms vary depending on the cause, but some symptoms are common to all types of obstruction.
Signs and tests
Physical examination may show decreased breath sounds . Tests are usually not necessary, but may include X-rays, bronchoscopy, and laryngoscopy.
TreatmentIf the victim has a complete obstruction and is unable to speak or breath, the Heimlich maneuver may be lifesaving. Treatment depends on the cause of the blockage. Aspirated objects may be able to be removed with laryngoscopy or 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 or cricothyrotomy).
Expectations (prognosis)Prompt treatment is often successful. However, the condition is dangerous and potentially fatal, even if treated.
ComplicationsInability to relieve the obstruction can cause breathing failure, brain damage, or death.
Calling your health care 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 get to a hospital. If an acute airway obstruction occurs, call 911 (or your local emergency number) for medical help and use what knowledge and materials are available to maintain breathing until medical help arrives.
Prevention is dependent on the cause of the upper airway obstruction. See the individual diseases in the above section for more information.
Update Date: 10/27/2003James L. Demetroulakos M.D. F.A.C.S., Department Of Otolaryngology, North Shore Medical Center, Salem, MA. Clinical Instructor in Otology and Laryngology Harvard Medical School. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT