Blockage of upper airway

  • 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).

  • Alternative Names
    • Airway obstruction - acute upper

  • 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)
      • Tracheomalacia (weakness of the cartilage that supports the trachea)
      • Vocal cord problems
  • Symptoms
  • 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.

  • 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.

  • 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 Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 60.