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Blockageofupperairway:MedlinePlusMedicalEncyclopedia

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Blockageofupperairway
Blockageoftheupperairwayoccurswhentheupperbreathingpassagesbecomenarrowedorblocked,
makingithardtobreathe.Areasintheupperairwaythatcanbeaffectedarethewindpipe(trachea),voicebox
(larynx)orthroat(pharynx).

Causes
Theairwaycanbecomenarrowedorblockedduetomanycauses,including:
Allergicreactionsinwhichthetracheaorthroatswellclosed,includingallergicreactionstoabeesting,
peanuts,antibiotics(suchaspenicillin),andbloodpressuremedicines(suchasACEinhibitors)
Chemicalburnsandreactions
Epiglottitis(infectionofthestructureseparatingthetracheafromtheesophagus)
Fireorburnsfrombreathinginsmoke
Foreignbodies,suchaspeanutsandotherbreathedinfoods,piecesofaballoon,buttons,coins,and
smalltoys
Infectionsoftheupperairwayarea
Injurytotheupperairwayarea
Peritonsillarabscess(collectionofinfectedmaterialnearthetonsils)
Retropharyngealabscess(collectionofinfectedmaterialinthebackoftheairway)
Throatcancer
Tracheomalacia(weaknessofthecartilagethatsupportsthetrachea)
Vocalcordproblems

Symptoms
Symptomsvary,dependingonthecause.Butsomesymptomsarecommontoalltypesofairwayblockage.
Theseinclude:

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Blockageofupperairway:MedlinePlusMedicalEncyclopedia

Agitationorfidgeting
Bluishcolortotheskin(cyanosis)
Changesinconsciousness
Choking
Confusion
Difficultybreathing
Gaspingforair
Panic
Unconsciousness
Wheezing,crowing,whistling,orotherunusualbreathingnoisesindicatingbreathingdifficulty

ExamsandTests
Thehealthcareproviderwilldoaphysicalexamination,whichmayshow:
Decreasedbreathsoundsinthelungs
Rapid,shallow,orslowedbreathing
Testsareusuallynotnecessary,butmayinclude:
Bronchoscopy
Laryngoscopy
Xrays

Treatment
Treatmentdependsonthecauseoftheblockage.
Objectsstuckintheairwaymayberemovedwithspecialinstruments.
Atubemaybeinsertedintotheairway(endotrachealtube)tohelpwithbreathing.
Sometimesanopeningismadethroughtheneckintotheairway(tracheostomyorcricothyrotomy).
Iftheobstructionisduetoaforeignbody,suchasapieceoffoodthathasbeenbreathedin,doingabdominal
thrustscansavetheperson'slife.

Outlook(Prognosis)
Prompttreatmentisoftensuccessful.Buttheconditionisdangerousandmaybefatal,evenwhentreated.
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PossibleComplications
Iftheobstructionisnotrelieved,itcancause:
Braindamage
Breathingfailure
Death

WhentoContactaMedicalProfessional
Airwayobstructionisoftenanemergency.Call911orthelocalemergencynumberformedicalhelp.Follow
instructionsonhowtohelpkeepthepersonbreathinguntilhelparrives.

Prevention
Preventiondependsonthecauseoftheupperairwayobstruction.
Thefollowingmethodsmayhelppreventanobstruction:
Eatslowlyandchewfoodcompletely.
Donotdrinktoomuchalcoholbeforeorwhileeating.
Keepsmallobjectsawayfromyoungchildren.
Makesuredenturesfitproperly.
Learnhowtoclearaforeignbodyfromtheairwayusingamethodsuchasabdominalthrusts.

AlternativeNames
Airwayobstructionacuteupper

References
CukorJ,MannoM.Pediatricrespiratoryemergencies:upperairwayobstructionandinfections.In:MarxJ,ed.
Rosen'sEmergencyMedicine:ConceptsandClinicalPractice.8thed.Philadelphia,PA:ElsevierMosby
2013:chap168.
ReardonRF,MasonPE,ClintonJE.Basicairwaymanagementanddecisionmaking.In:RobertsJR,ed.
Roberts&Hedges'ClinicalProceduresinEmergencyMedicine.6thed.Philadelphia,PA:ElsevierSaunders
2014:chap3.
ThomasSH,GoodloeJM.Foreignbodies.In:MarxJ,ed.Rosen'sEmergencyMedicine:Conceptsand
ClinicalPractice.8thed.Philadelphia,PA:ElsevierMosby2013:chap60.
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UpdateDate7/6/2015
Updatedby:JacobL.Heller,MD,MHA,EmergencyMedicine,VirginiaMasonMedicalCenter,Seattle,WA.
AlsoreviewedbyDavidZieve,MD,MHA,IslaOgilvie,PhD,andtheA.D.A.M.Editorialteam.

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