What is an acute upper airway obstruction?

An acute upper airway obstruction (UAO) is a blockage that 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 can cause brain damage, and even a heart attack, in a matter of minutes. Any obstruction of the 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 UAO are:

  • anaphylaxis
  • croup
  • epiglottitis

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

Anaphylaxis

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 certain medications, such as penicillin, that may cause a severe reaction.

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 may be caused by anything from an infection to simply drinking coffee that’s too hot. Epiglottitis can block the flow of air to your lungs, and 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 isn’t 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 symptoms may vary, some are common no matter what caused your obstruction.

Some of the most common symptoms of an obstruction, from least to most severe, are:

Cyanosis can also appear as a sign of acute UAO, depending on the severity and duration of your blockage. Cyanosis occurs when there isn’t 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 in these areas of your body, seek emergency medical treatment immediately.

Emergency treatment of an upper airway obstruction

Treatment of your UAO 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 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 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, possibly saving 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 speed up your recovery. If symptoms remain or get worse, your doctor might put you on corticosteroids, which are medications that help reduce inflammation. For croup resulting from an infection, your doctor might also prescribe antibiotics.

Children have small airways and are at highest risk of complications 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, they need immediate medical attention.

Foreign objects

If your child has inhaled a foreign object, and can’t cough, speak, or breathe, call 911. In the meantime, for children 12 months and older, the American Red Cross recommends that you administer five blows to the back, below the shoulder blades with the heel of your hand. The blows should be strong, but not to the point of being painful. Then give five abdominal thrusts, also called the Heimlich maneuver, as follows:

  1. Stand behind your child and wrapping your arms around their waist.
  2. Place the thumb side of your fist right above the child’s belly button.
  3. Use a quick, upward thrust to press your fist into their 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.

For infants younger than 12 months, don’t use the Heimlich maneuver. Use back blows and chest thrusts instead.

For back blows:

  1. Lay the infant face down along your thighs.
  2. Use the heel of your hand to give the infant five back blows to the center of the back.

To give chest thrusts:

  1. Lay the baby face up along your thighs.
  2. With two fingers, give five sharp chest pushes in the middle of the breast bone.