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Blockage of upper airway

Airway obstruction - acute upper

 

Blockage of the upper airway occurs when the upper breathing passages become narrowed or blocked, making it hard to breathe. Areas in the upper airway that can be affected are the windpipe (trachea), voice box (larynx) or throat (pharynx).

Causes

 

The airway can become narrowed or blocked due to many causes, including:

  • Allergic reactions in which the trachea or throat swell closed, including allergic reactions to a bee sting , peanuts, antibiotics (such as penicillin), and blood pressure medicines (such as ACE inhibitors)
  • Chemical burns and reactions
  • 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
  • Infections of the upper airway area
  • Injury to the upper airway area
  • Peritonsillar abscess (collection of infected material near the tonsils)
  • Retropharyngeal abscess (collection of infected material in the back of the airway)
  • Throat cancer
  • Tracheomalacia (weakness of the cartilage that supports the trachea)
  • Vocal cord problems

 

Symptoms

 

Symptoms vary, depending on the cause. But some symptoms are common to all types of airway blockage. These 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

 

The health care provider will do a physical examination, which 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

 

Treatment depends on the cause of the blockage.

  • Objects stuck in the airway may be removed with special instruments.
  • A tube may be inserted into the airway ( endotracheal tube ) to help with breathing.
  • Sometimes an opening is made through the neck into the airway ( tracheostomy or cricothyrotomy).

If the obstruction is due to a foreign body, such as a piece of food that has been breathed in, doing abdominal thrusts can save the person's life.

 

Outlook (Prognosis)

 

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

 

Possible Complications

 

If the obstruction is not relieved, it can cause:

  • Brain damage
  • Breathing failure
  • Death

 

When to Contact a Medical Professional

 

Airway obstruction is often an emergency. Call 911 or the local emergency number for medical help. Follow instructions on how to help keep the person breathing until 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.
  • Do not drink too much alcohol before or while eating.
  • Keep small objects away from young children.
  • Make sure dentures fit properly.

Learn how to clear a foreign body from the airway using a method such as abdominal thrusts.

 

 

Open References

References

Cukor J, Manno M. Pediatric respiratory emergencies: upper airway obstruction and infections. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 168.

Reardon RF, Mason PE, Clinton JE. Basic airway management and decision-making. In: Roberts JR, ed. Roberts & Hedges' Clinical Procedures in Emergency Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 3.

Thomas SH, Goodloe JM. Foreign bodies. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practic e. 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 60.

 
  • Throat anatomy

    Throat anatomy - illustration

    Structures of the throat include the esophagus, trachea, epiglottis and tonsils.

    Throat anatomy

    illustration

  • Choking

    Choking - illustration

    Choking is the hindrance of breathing due to an obstruction of the throat or windpipe. The Heimlich maneuver should be conducted to try to dislodge the object.

    Choking

    illustration

  • Respiratory system

    Respiratory system - illustration

    Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

    Respiratory system

    illustration

    • Throat anatomy

      Throat anatomy - illustration

      Structures of the throat include the esophagus, trachea, epiglottis and tonsils.

      Throat anatomy

      illustration

    • Choking

      Choking - illustration

      Choking is the hindrance of breathing due to an obstruction of the throat or windpipe. The Heimlich maneuver should be conducted to try to dislodge the object.

      Choking

      illustration

    • Respiratory system

      Respiratory system - illustration

      Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

      Respiratory system

      illustration

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Blockage of upper airway

           
             

            Review Date: 7/6/2015

            Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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