Acute upper airway obstruction from any cause can be a life-threatening emergency. Complete obstruction will result in respiratory failure followed by cardiac arrest in a matter of minutes. This situation requires an immediate, aggressive response.
In contrast, a child with a partial obstruction may initially have an adequate airway. However, this condition can deteriorate rapidly. Under these circumstances, providing supportive care and mobilizing resources for definitive airway management may be the most appropriate intervention.
Compared with adults, infants and young children have small airways and can quickly develop clinically significant upper airway obstruction. The increased work of breathing that results can rapidly progress to respiratory failure because these young patients have less respiratory reserve. Therefore, prompt recognition of airway compromise and the institution of appropriate therapy are necessary to prevent progressive deterioration in respiratory function and improve outcomes.
This topic will review an emergent diagnostic and therapeutic approach to acute severe upper airway obstruction in children. The emergent evaluation of children with acute respiratory distress and issues related to stridor, chronic upper airway problems, and airway management techniques for the difficult pediatric airway are discussed separately.