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Acute upper airway obstructionAn acute upper airway obstruction is a blockage of the upper airway, which can be in the trachea, voice box

(laryngeal), or throat (pharyngeal) areas.

Causes

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 (infection of the structure separating the trachea from the esophagus)

Fire or burns from breathing in smoke

Foreign bodies -- such as peanuts and other breathed-in foods, pieces of a balloon, buttons, coins, and small

toys

Viral or bacteria infections

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 airway blockage. They

include:

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

Exams 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:

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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 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).

Outlook (Prognosis)

Prompt treatment is often successful. However, the condition is dangerous and may be fatal, even if treated.

Possible Complications

Inability to relieve the obstruction can cause:

Brain damage

Breathing failure

Death

When to Contact a Medical Professional

Airway 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.

Prevention

Prevention 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

Alternative Names

Airway obstruction - acute upper

References

Manno 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.

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Update Date: 7/16/2011

Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington,

Clinic. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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