Upper Airway Obstruction

Question 1

What are the causes of upper airway obstruction?

Answer 1

• self-inserted by children
• blunt laryngotracheal trauma
• penetrating laryngotracheal trauma
• tonsillar hypertrophy
• paralysis of the vocal cord or vocal fold
• acute laryngotracheitis such as viral croup
• bacterial tracheitis
• epiglottitis
• peritonsillar abscess
• pertussis

Question 2

How should suspected upper airway obstructed be Ix?

Answer 2

• Auroscope to examine nose

- Imaging = CXR (PA, lateral), CT, MRI

Question 3

Outline the best Mx for an upper airway obstruction

Answer 3

• blow nose
• parental kiss (blowing into the mouth, whilst occluding the other nostril)
• grasp object with crocodile forceps
• refer to ENT if failed attempt or uncooperative pt

Assess severity

• effective cough = encourage cough
• ineffective cough = unconscious (open airway, 5 breaths, start CPR), conscious (5 back blows, 5 thrusts)

Question 4

What are the possible complications of an upper airway obstruction?

Answer 4

• bleeding
• resp failure
• malignancy to progress

Question 5

How does an upper airway obstruction present?

Answer 5

• Organic = purulent unilateral discharge

- Inorganic = may remain inert for ages