Recognition of Upper Airway Obstruction

Recognition of Upper Airway Obstruction

Airway obstruction may be partial or complete, and present in the conscious or the unconscious person. Typical causes of airway obstruction may include, but are not limited to:

• Relaxation of the airway muscles due to unconsciousness
• Inhaled foreign body.
• Trauma to the airway
• Anaphylactic reaction.

The symptoms and signs of obstruction will depend on the cause and severity of the condition.

Airway obstruction may occur gradually or suddenly and may lead to complete obstruction within a few seconds. As such the person should be observed continually.

In the conscious person who has inhaled a foreign body, there may be extreme anxiety, agitation, gasping sounds, coughing or loss of voice. This may progress to the universal choking sign, namely clutching the neck with the thumb and fingers (as shown in Figure 3).

Airway obstruction will cause the diaphragm muscle to work harder to achieve adequate ventilations. The abdomen will continue to move out but there will be loss of the natural rise of the chest (paradoxical movement), and in-drawing of the spaces between the ribs and above the collar bones during inspiration.

Partial obstruction can be recognised where:

• Breathing is laboured.
• Breathing may be noisy.
• Some escape of air can be felt from the mouth.

Complete obstruction can be recognised where:

• There may be efforts at breathing.
• There is no sound of breathing.
• There is no escape of air from nose and/or mouth.

Airway obstruction may not be apparent in the non-breathing unconscious person until rescue breathing is attempted.

It is better to be getting SOME air, than NO air at all.