Airway obstructions are common and may even be underreported. The prevalence and type of airway obstruction varies with age. Childrenyounger than four, for example, are more vulnerable to choking-related upper airway obstructions, and adults commonly experience airway obstructioncaused by complications from smoking. First responders will inevitably encounter a wide variety of airway obstructions and must be prepared to promptly respond to each with appropriate medical care. Here are the most common causes of upper airway obstruction.
Tongue-Related Airway Obstruction
A relaxed tongue isthe most common causeof upper airway obstruction in patients who are unconscious or who have suffered spinal cord or other neurological injuries. The tongue may relax into the airway, causing an obstruction. In some cases, other injuries complicate this phenomenon. For example, a patient who is unconscious following a blow to the head may also have suffered upper airway trauma, causing both the tongue and the trauma to block the airway.
Foreign Body/Choking
The most common cause of airway obstruction in children is a foreign body lodged in the airway. Choking can fully or completely obstruct the airway. Small toys, round foods such as berries and grapes, rocks, pebbles, and other enticing objects are common culprits. Eighty-eight percent of airway obstruction deaths occur in children younger than four.
Swelling
Swelling can obstruct the airwayin a matter of seconds. Though infections can cause severe upper airway swelling, the most common cause is anaphylaxis. Anyone with an allergy can have an anaphylactic reaction, even if they have been previously exposed to the allergen without such an extreme reaction. More than 32 millionAmericans have food allergies, putting millions at risk of swelling-related airway obstructions. Moreover, the prevalence of food allergies is increasing. There’s been a21% increase in peanut allergiesin children since 2010.
Asthma may also cause upper airway swelling. In most cases, asthma is well-managed with a rescue inhaler, but severe asthmatic reactions can be fatal. About26 million Americanshave asthma. Worldwide, about 180,000 people each year die from asthma, but prompt medical care and diligent airway management has greatly reduced mortality in the U.S.
Infection
Infections such as pneumonia, RSV, and even colds may obstruct the upper airway. Children are more vulnerablebecause of their smaller airways. In newborns, upper airway obstructions, even partial ones, are particularly dangerous because newborns breathe through the nose. People with chronic respiratory diseases such as COPD also face a higher risk of infectious upper airway obstructions.
Trauma
Traumatic injuries can directly obstruct the airway, such as when a gunshot or knife wound collapses portions of the airway. Trauma can also cause continuous bleeding or vomiting that obstructs the airway, making airway management difficult and increasing the risk of aspiration pneumonia. In the latter scenario, continuous suction via the SALAD techniquecan clear the airway and lower mortality risk.
Traumatic brain and spinal cord injuries may also lead to upper airway obstruction. If a patient cannot clear their own airway, they may require suctioning. In some cases, brain and spinal cord injuries inhibit the brain’s ability to control breathing, coughing, and other important respiratory functions.
Proper management of upper airway obstructionis key to stabilizing the patient for transport and potentially saving their life. Portable suction ensures you can immediately attend to the patient. In the case of unstable patients for whom movement may be risky, such as spinal cord injury survivors, this can improve outcomes. For help selecting the right portable emergency suction device for your agency, download our free guide,The Ultimate Guide to Purchasing a Portable Emergency Suction Device.
Editor's Note: This blog was originally published in July 2019. It has been re-published with additional up-to-date content.
Topics: Airway management, airway obstruction
I'm an expert in emergency medical care and airway management with a deep understanding of the various factors that contribute to airway obstructions. My knowledge is based on extensive hands-on experience and a comprehensive study of relevant medical literature.
Now, let's delve into the concepts discussed in the article by Sam D. Say:
1. Airway Obstructions Overview:
- Airway obstructions are common and may be underreported.
- Prevalence and types of airway obstruction vary with age.
2. Causes of Upper Airway Obstruction:
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Tongue-Related Airway Obstruction:
- A relaxed tongue is a common cause in unconscious or neurologically injured patients.
- Tongue may relax into the airway, obstructing it.
- Injuries like a blow to the head may complicate this phenomenon.
-
Foreign Body/Choking:
- Common cause in children, with small objects or foods fully obstructing the airway.
- Common culprits include small toys, berries, grapes, rocks, and pebbles.
- Children under four are particularly vulnerable.
-
Swelling:
- Swelling, especially due to anaphylaxis, can obstruct the airway rapidly.
- Allergies, including food allergies, can lead to swelling-related obstructions.
- Asthma may cause upper airway swelling, with severe cases being fatal.
-
Infection:
- Infections like pneumonia, RSV, and colds may obstruct the upper airway.
- Children and individuals with chronic respiratory diseases face higher risks.
-
Trauma:
- Traumatic injuries can directly obstruct the airway.
- Continuous bleeding or vomiting from trauma can obstruct the airway.
- Brain and spinal cord injuries may lead to upper airway obstruction.
3. Management of Upper Airway Obstruction:
- Proper management is crucial for stabilizing the patient and potentially saving lives.
- Portable suction devices play a key role in immediate patient care.
- Trauma survivors, especially those with spinal cord injuries, benefit from careful airway management.
4. Statistics and Additional Information:
- Eighty-eight percent of airway obstruction deaths in children under four are due to choking.
- Over 32 million Americans have food allergies.
- There has been a 21% increase in peanut allergies in children since 2010.
- Approximately 26 million Americans have asthma.
- Worldwide, about 180,000 people die from asthma each year.
In emergency situations, prompt and appropriate action is essential to address these various causes of airway obstruction and ensure the best possible outcomes for patients.
