Acute Upper Airway Obstruction

Written by Carmella Wint | Published on April 17, 2012
Medically Reviewed by George Krucik, MD

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, 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, have an obstructed upper airway.

What Can Cause the Obstruction?

Three of the most common causes of UAO are: anaphylaxis, croup, and epiglottitis. Your airway can also be obstructed if you inhale a foreign object.

Anaphylaxis

Anaphylaxis is a severe allergic reaction that can appear within just minutes of coming into contact with an allergen. An allergen is something that triggers an allergy. Anaphylaxis can be fatal. During an anaphylactic reaction, your airways can swell, obstructing your breathing. Peanuts and bee stings are among the most common anaphylaxis-causing allergens.

Epiglottitis

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 can 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 so it can be potentially life threatening.

Croup

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 a 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 call your doctor and seek emergency help as soon as you suspect a 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 a 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 even 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.

Anaphylaxis

Due to its potentially life-threatening consequences, anaphylaxis requires speedy 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 to help you breathe and reduce swelling. If you already know that you are at risk for anaphylaxis, your doctor may have already given you an autoinjector. An autoinjector 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.

Epiglottitis

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

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.

Foreign Objects

If your child has inhaled a foreign object, it’s best to seek medical attention. According to the Mayo Clinic, the American Red Cross recommends that you administer five strong, but not painful, blows to the back, below the shoulder blades (MayoClinic). If you don’t feel comfortable doing this or would like to try a dual approach, the Heimlich maneuver may also be used. This technique allows you to dislodge the obstruction by:

  • wrapping your arms around the waist of the affected person
  • placing a 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

This is typically repeated five times. You can alternate between back blows and the Heimlich maneuver to try to remove the obstruction while you wait for emergency assistance.

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