ACUTE UPPER AIRW...

Images and Slideshows

Choking

Throat anatomy

Respiratory system

Definition

An 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 Names

Airway obstruction - acute upper; Choking

Causes, incidence, and risk factors

Causes 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 reactions
• Croup
• Epiglottitis
• Fire or burns from breathing in smoke
• Foreign bodies -- such as peanuts and other breathed-in foods, balloon fragments, buttons, coins, and small toys
• Infections with viruses or bacteria
• Peritonsillar abscess
• Retropharyngeal abscess
• Throat cancer
• Tracheomalacia
• Trauma
• Vocal cord problems

Symptoms

Symptoms vary depending on the cause, but some symptoms are common to all types of obstruction.

• Agitation or fidgeting
• Bluish color to the skin (cyanosis)
• Changes in consciousness
• Choking
• Confusion
• Difficulty breathing
• Gasping for air
• Panic
• Unconsciousness
• Wheezing, crowing, whistling, or other unusual breathing noises indicating breathing difficulty

Signs and tests

Physical examination may show:

• Decreased breath sounds in the lungs
• Rapid, shallow, or slowed breathing

Tests are usually not necessary, but may include:

• Bronchoscopy
• Laryngoscopy
• X-rays

Treatment

If 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 lodged 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.

Complications

Inability to relieve the obstruction can cause:

• Brain damage
• Breathing failure
• Death

Reviewer Info: A.D.A.M. Editorial Team: David Zieve, MD, MHA, Greg Juhn, MTPW, David R. Eltz. Previously reviewed by Jacob L. Heller, MD, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington, Clinic (10/2/2008)., 02/11/2009