Acute Upper Airway Obstruction

Acute Upper Airway Obstruction

What Is an Acute Upper Airway Obstruction?

An acute upper airway obstruction (UAO) is when a blockage occurs in your upper airway. The upper airway of your respiratory system consists of the trachea, larynx or voice box, and throat. A blockage in your airway could prevent your body from getting enough oxygen.

A lack of oxygen could cause brain damage, and even a heart attack, in a matter of minutes. Any obstruction of your upper airway has the potential to be life threatening. Seek emergency medical attention immediately if you suspect that you, or someone you know, has an obstructed upper airway.

What Can Cause the Obstruction?


Three of the most common causes of acute upper airway obstruction (UAO) are:

  • anaphylaxis
  • croup
  • epiglottitis

Your airway can also be obstructed if you inhale a foreign object or food.


Anaphylaxis is a severe allergic reaction that can happen within minutes of coming into contact with an allergen. An allergen is a substance that triggers an allergic reaction in your body. Anaphylaxis can be fatal. During an anaphylactic reaction, your airway swells and obstructs your breathing. Peanuts and bee stings are among the most common anaphylaxis-causing allergens. Some people are allergic to a medication, such as Penicillin that may cause a severe reaction.


Epiglottitis is a condition that occurs as a result of the epiglottis becoming swollen. The epiglottis is a flap of cartilage that covers the opening of your windpipe. Swelling may be caused by anything from an infection to simply drinking coffee that is too hot. Epiglottitis can block the flow of air to your lungs and it can be potentially life threatening.


Croup is a condition that usually causes a harsh, barking cough. The barking cough is caused by an inflamed windpipe and vocal cords. The swollen windpipe causes the vibration of your vocal cords to sound different. Croup is not considered to be a severe condition and it can usually be treated at home.

Foreign Objects

Inhaling a foreign object, like a nut or bead, can cause acute UAO. A foreign object can get stuck in your throat or other air passage, causing an obstruction. While foreign objects can be inhaled accidentally at any age, this is most commonly seen in toddlers and small children.

When Should I Alert My Doctor?


You should seek emergency help as soon as you suspect acute UAO. While your symptoms may vary, some symptoms are common no matter what caused your obstruction. Some of the most common signs of an obstruction, from least to most severe, are:

  • agitation
  • confusion
  • panic
  • drooling
  • swelling of the face and tongue
  • difficulty breathing
  • wheezing and other unusual breath sounds
  • choking
  • unconsciousness

Cyanosis can also appear as a sign of acute UAO, depending on the severity and duration of your blockage. Cyanosis occurs when there is not enough oxygen in the blood. The lack of oxygen can give your skin, lips, and fingernails a bluish color. If you notice a bluish tint to your appearance, seek emergency medical treatment immediately.

Emergency Treatment of an Upper Airway Instruction


Treatment of your upper airway obstruction will depend on the cause. Regardless of the source of your obstruction, prompt medical attention is extremely important.


Due to its potentially life-threatening consequences, anaphylaxis requires immediate treatment. If you suspect that you or someone you know is having an anaphylactic reaction, call 911.

Treatment for anaphylaxis may involve the use of oxygen as well as antihistamines and anti-inflammatory drugs to help you breathe and reduce the swelling. If you know that you’re at risk for anaphylaxis, your doctor may have already given you an auto-injector. An auto-injector is a syringe that carries a premeasured dose of epinephrine, or adrenaline, in it. Epinephrine can effectively stop your anaphylaxis and it may save your life.


To treat epiglottitis your doctor will first want to make sure that you’re able to breathe. This is usually done by administering oxygen using a mask or breathing tube. If you have epiglottitis as a result of an infection, antibiotics will be prescribed.


Croup can usually be treated at home. Breathing moist air with the help of a humidifier and drinking plenty of fluids can help speed up your recovery. If symptoms remain or get worse, your doctor might put you on corticosteroids, which are medications that help reduce inflammation. If an infection caused your croup, antibiotics may be given. Children have small airways and are at highest risk of complication related to airway swelling. If a child with croup begins to make a high pitched noise when inhaling or exhaling, seems agitated, or struggles to breathe seek immediate medical attention.

Foreign Objects

If your child has inhaled a foreign object, and cannot cough, speak, or breathe, call 911. In the meantime, the American Red Cross recommends that you administer five strong, but not painful, blows to the back, below the shoulder blades with the heel of your hand. Then, give five abdominal thrusts, also called the Heimlich maneuver. Do this by:

  • standing behind your child and wrapping your arms around their waist
  • placing the thumb side of your fist right above the affected person’s belly button
  • using a quick, upward thrust to press your fist into the abdomen with the help of your available hand

Alternate between five back blows and five abdominal thrusts to try to remove the obstruction while you wait for emergency assistance.

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