Definition of Acute upper airway obstruction:

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.

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

Calling your health care provider:

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. See the individual diseases in the above section for more information.

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