Airway obstruction Flashcards
What features of anatomy in children make airway compromise more likely?
Small, soft larynx; weak neck muscles and heavy/floppy head; obligate nasal breathers; relatively large tongue; narrow subglottis; larynx is at higher position (C1)
If an airway of 2mm is reduced by 1mm what is the corresponding increase in flow resistance? What effect does this have on the work of breathing?
16x. Increases the work of breathing
Name 5 potential causes of airway obstruction.
Inflammatory/Allergic Infective Trauma Foreign body Neurological
What are sternal/subcostal recession and tracheal tug a sign of?
Severe respiratory distress in children. Occurs as a result of subatmospheric inter-thoracic pressures
What skin colour might be seen in airway compromise?
“Dusky”, blue
What is stridor?
Harsh, high-pitched inspiratory “wheeze” caused by airway obstruction
What is stertor?
A “snoring”, “gasping” inspiratory sound originating from the nasopharyngeal airway
Why is epiglottitis now less common in children?
Immunisation against haemophilus influenziae B
Is airway obstruction a late or early stage of epiglottitis?
Very late
What are the most common causes of malignant airway obstruction?
Extrinsic tumours. For example lung, oesophageal and thyroid carcinomas
Where is the narrowest point of a child’s airway?
Subglottic space (just below the vocal cords)
How might subglottic stenosis occur?
Congenital malformation; infection; GORD; tracheotomy (especially in premature babies)
What signs might indicate a compromised airway?
Increased work of breathing (accessory muscle use, sternal indrawing, tracheal tug) Central cyanosis Inability to complete sentences Stridor/stertor Absent chest sounds
What does respiratory failure/arrest ultimately lead to?
Cardiac failure and consequently neurological failure
What approach should be used in airway management?
A B C
