HEALTH ENCYCLOPEDIA

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Airway Obstruction

What is an airway obstruction?

An airway obstruction is a blockage in any part of the airway. The airway is a complex system of tubes that conveys inhaled air from your nose and mouth into your lungs. An obstruction may partially or totally prevent air from getting into your lungs. Some airway obstructions are minor while others are life-threatening emergencies that require immediate medical attention.

Types of airway obstructions

The types of airway obstructions are classified based on where the obstruction occurs and how much it blocks.

  • Upper airway obstructions occur in the area from your nose and lips to your larynx (voice box).
  • Lower airway obstructions occur between your larynx and the narrow passageways of your lungs.
  • Partial airway obstructions allow some air to pass. You can still breathe with a partial airway obstruction, but it will be difficult.
  • Complete airway obstructions do not allow any air to pass. You cannot breathe if you have a complete airway obstruction.
  • Acute airway obstructions are blockages that occur quickly. An example of an acute airway obstruction is choking on a foreign object.
  • Chronic airway obstructions occur two different ways. These can be blockages that take a long time to develop, or blockages that last for a long time.

What causes an airway obstruction?

The classic image of an airway obstruction is someone choking on a piece of food. But that’s only one of many things that can cause an airway obstruction. Other causes include:

  • inhaling or swallowing a foreign object
  • a small object becoming lodged in the nose or mouth
  • allergic reactions
  • trauma to the airway from an accident
  • vocal cord problems
  • breathing in a large amount of smoke from a fire
  • viral infections
  • bacterial infections
  • a respiratory illness that causes upper airway inflammation, called croup
  • swelling of the tongue or epiglottis
  • abscesses in the throat or tonsils
  • a collapse of the tracheal wall, known as tracheomalacia
  • asthma
  • chronic bronchitis
  • emphysema
  • cystic fibrosis
  • chronic obstructive pulmonary disease

Who is at risk for an airway obstruction?

Children have a higher risk of obstruction by foreign objects than adults. They’re more likely to stick toys and other small objects in their noses and mouths. They may also fail to chew food well before swallowing.

Other risk factors for airway obstruction include:

  • having severe allergies to insects such as bees, or foods such as peanuts
  • birth defects or inherited diseases that can cause airway problems
  • smoking
  • people who have a difficult time swallowing food properly, such as those who have neuromuscular disorders

What are the symptoms of an airway obstruction?

The symptoms of an airway obstruction depend on the cause. They also depend on the location of the obstruction. Symptoms you may experience include:

  • agitation
  • cyanosis, or bluish-colored skin
  • confusion
  • difficulty breathing
  • gasping for air
  • panic
  • high-pitched breathing noises such as wheezing
  • unconsciousness

How is an airway obstruction diagnosed?

Airway obstructions are diagnosed by evaluating your signs and symptoms. Doctors look for signs that include:

  • alterations in your normal breathing pattern, whether rapid or shallow breathing
  • decreased breath sounds in your lungs
  • high-pitched breath sounds in the upper airway or mouth
  • no breathing
  • bluish skin color
  • unconsciousness

Certain tests may also be used to determine the cause of your airway obstruction. During an emergency, your doctor will likely order an X-ray first to determine the cause of your symptoms. If an X-ray fails to determine the cause of the obstruction, your doctor may choose to order more advanced testing. This may include a bronchoscopy. During this procedure, your doctor inserts an instrument called a bronchoscope through your mouth or nose to look into your lungs for any foreign bodies. Bronchoscopy can also help your doctor evaluate different causes of obstruction. This includes tracheomalacia, or weakness and collapse of the trachea. It also includes infectious causes, such as mucous plugging in patients with chronic lung conditions like emphysema and cystic fibrosis.

Your doctor may also order a laryngoscopy. During this procedure, your doctor will examine your larynx with an instrument called a laryngoscope. Additional tests may include a CT scan of the head, neck, or chest to determine other sources of obstruction, such as epiglottitis. This is an infection and inflammation of the epiglottis. The epiglottis is the flap of tissue that protects and covers your trachea from food and foreign bodies.

How is an airway obstruction treated?

An airway obstruction is usually an emergency situation. You should call 911 if you see someone experiencing an airway obstruction. Some things you can do while you’re waiting for emergency services to arrive include:

The Heimlich maneuver  

This is an emergency technique that may help a person who is choking on a foreign object. The maneuver involves one person standing behind the person who is choking, wrapping their arms around their waist. The person performing the maneuver should then make a fist with one hand and put it near the person’s bellybutton. They should then grab first with their other hand, and press into the person’s abdomen with five quick thrusts. Repeat the cycle of five back blows and five abdominal thrusts until the object becomes dislodged, or emergency services arrive. 

Epinephrine

Epinephrine can be used to treat airway swelling due to an allergic reaction. People with severe allergies, such as those with allergies to food or bee stings, can develop sudden and rapid swelling of the throat and tongue. This can lead to near or complete airway obstruction within minutes. People who have severe allergies usually carry EpiPens. These are simple injectors containing epinephrine.

People who carry EpiPens are instructed to deliver one injection into the outer thigh as soon as they experience symptoms of a severe allergic reaction. An epinephrine injector can help a person experiencing anaphylactic shock while they are waiting for medical services to arrive. Medical professionals should always evaluate people who receive epinephrine injections as soon as possible.

Cardiopulmonary resuscitation (CPR)

CPR is used when a person is unable to breathe and has lost consciousness. It keeps oxygenated blood flowing to the brain until emergency services arrive. To perform CPR, you should place the heel of your hand in the center of their chest. Place your other hand on top, and use your upper body weight to push straight down on the chest. You should do this about 100 times in a minute until an ambulance arrives.

Once an ambulance has arrived, there are several different ways airway obstruction can be treated based on what caused it.

An endotracheal or nasotracheal tube may be inserted into the airway. This can help get oxygen through swollen airways. A tracheostomy and cricothyrotomy are surgical openings made in the airway to bypass an obstruction. These procedures should be performed by highly trained medical professionals and are generally required when all of the above interventions have failed.

Prognosis after airway obstruction

With prompt treatment, an airway obstruction can often be treated successfully. However, airway obstructions are extremely dangerous. They can be fatal even with treatment.

If you or someone you know may have an airway obstruction, get help immediately.

Prevention of airway obstruction

Many types of airway obstructions can be prevented. Reduce your risk by doing the following:

  • Avoid drinking a lot of alcohol before eating.
  • Eat small bites of food.
  • Eat slowly.
  • Supervise small children when eating.
  • Chew thoroughly before swallowing.
  • Make sure your dentures fit properly.
  • Keep small objects away from children.
  • Do not smoke.
  • Visit your doctor regularly if you have a condition that can cause a chronic airway obstruction.

Content licensed from:

Written by: Rose Kivi
Published on: Sep 28, 2012on: Apr 20, 2016

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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