Blockage of upper airway

Alternative Names

Airway obstruction - acute upper

Definition

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 various 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 medications (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.

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

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:

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.

It is a good idea to learn how to clear an airway of a foreign body by using a method such as abdominal thrusts.

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.

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: Elsevier Mosby; 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: Elsevier Mosby; 2009:chap 57.

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; 2013:chap 3.