Acute upper airway obstruction

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Choking

Respiratory system

Throat anatomy

An acute upper airway obstruction is a blockage of the upper airway, which can be in the trachea, laryngeal (voice box), or pharyngeal (throat) areas.

Airway obstruction - acute upper; Choking

Acute upper airway obstruction may have any of a number of causes including viral and bacterial infections, fire or inhalation burns, chemical burns and reactions, allergic reactions, foreign bodies, and trauma. The blockage can be complete or partial. Mild obstruction may result in air hunger, while more severe obstruction can lead to cyanosis (a bluish discoloration of the skin or mucous membranes caused by lack of oxygen in the blood), confusion, or unconsciousness. Complete obstruction, if not corrected, leads to rapid suffocation and death.

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Symptoms of acute upper airway obstruction are dramatic and easy to diagnose. The individual may suddenly begin having difficulty breathing or be unable to breathe at all. Cyanosis, unconsciousness, and death may rapidly follow a large or total obstruction.

Common causes of acute upper airway obstruction include:

• Foreign bodies
  • In adults, foreign bodies are usually inhaled bits of food. In children, peanuts are the most commonly inhaled food, but hot dogs are the most common food item associated with choking deaths, because of their size and shape. Children also commonly choke on many nonfood items, such as balloon fragments, buttons, coins, and small toys.
• Anaphylaxis
  • Acute allergic reactions in which the trachea or throat swell closed are a common cause of airway obstruction. The classic example is an allergic reaction to a bee sting , which frequently takes the form of an anaphylactic reaction. Other common causes include allergy reaction to peanuts, antibiotics (penicillin), and blood pressure medications (ACE inhibitors).
• Croup
  • Croup may lead to a fairly rapid decrease in airway diameter and marked respiratory distress.
• Epiglottitis
  • Acute bacterial epiglottitis can cause rapid airway obstruction as the epiglottis swells and occludes the airway. Acute epiglottitis is preventable by vaccination against H. influenzae bacteria.
• Retropharyngeal abscess
  • A rapidly expanding abscess can block the airway and cause respiratory distress.
• Peritonsillar abscess
  • Obstruction similar to retropharyngeal abscess.

Review Date: 08/03/2005
Reviewed By: Alden J. Pearl M.D., Clinical Assistant Professor, Department of Otolaryngology, State University of New York Health Science Center at Brooklyn, Brooklyn, NY. Review provided by VeriMed Healthcare Network.