Emergency evaluation of acute upper airway obstruction in children
- Laura L Loftis, MD
Laura L Loftis, MD
- Associate Professor of Pediatrics
- Baylor College of Medicine
- Section Editors
- Stephen J Teach, MD, MPH
Stephen J Teach, MD, MPH
- Section Editor — Pediatric Signs and Symptoms
- Professor of Pediatrics and Emergency Medicine
- George Washington University School of Medicine and Health Sciences
- Adrienne G Randolph, MD, MSc
Adrienne G Randolph, MD, MSc
- Section Editor — Pediatric Critical Care Medicine
- Professor of Anaesthesia and Pediatrics
- Harvard Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
This topic will review an emergency diagnostic and therapeutic approach to acute severe upper airway obstruction in children. The emergent evaluation of children with acute respiratory distress and airway management techniques for the difficult pediatric airway are discussed separately.
●(See "The difficult pediatric airway".)
- Chan SC, Dawes PJ. The management of severe infectious mononucleosis tonsillitis and upper airway obstruction. J Laryngol Otol 2001; 115:973.
- Vilke GM, Smith AM, Ray LU, et al. Airway obstruction in children aged less than 5 years: the prehospital experience. Prehosp Emerg Care 2004; 8:196.
- Chatterjee D, Agarwal R, Bajaj L, et al. Airway management in laryngotracheal injuries from blunt neck trauma in children. Paediatr Anaesth 2016; 26:132.
- Yen K, Flanary V, Estel C, et al. Traumatic epiglottitis. Pediatr Emerg Care 2003; 19:27.
- Fein A, Leff A, Hopewell PC. Pathophysiology and management of the complications resulting from fire and the inhaled products of combustion: review of the literature. Crit Care Med 1980; 8:94.
- Rahbar R, Rowley H, Perez-Atayde AR, et al. Delayed presentation of lymphatic malformation of the cervicofacial region: role of trauma. Ann Otol Rhinol Laryngol 2002; 111:828.
- Recognition of respiratory distress and failure. Samson RA, Schexnayder SM, Hazinski MF, et al (Eds). Pediatric Advanced Life Support Provider Manual. American Heart Association, Dallas, 2016, p. 113.
- Langhelle A, Sunde K, Wik L, Steen PA. Airway pressure with chest compressions versus Heimlich manoeuvre in recently dead adults with complete airway obstruction. Resuscitation 2000; 44:105.
- Pawar DK, Marraro GA. One lung ventilation in infants and children: experience with Marraro double lumen tube. Paediatr Anaesth 2005; 15:204.
- Riquelme M, Monnet E, Kudnig ST, et al. Cardiopulmonary changes induced during one-lung ventilation in anesthetized dogs with a closed thoracic cavity. Am J Vet Res 2005; 66:973.
- Darras KE, Roston AT, Yewchuk LK. Imaging Acute Airway Obstruction in Infants and Children. Radiographics 2015; 35:2064.
- Nagler J, Luten RC. The difficult pediatric airway. In: The Walls Manual of Emergency Airway Management, 5th ed, Brown CA (Ed), Wolters Kluwer, Philadelphia 2018.
- Hoppa E, Perry H. Stridor. In: Fleisher and Ludwig's Textbook of Pediatric Emergency Medicine, 7th ed, Shaw KN, Bachur RG (Eds), Wolters Kluwer, Philadelphia 2016. p.486.
- - Croup
- - Bacterial tracheitis
- - Retropharyngeal abscess
- - Peritonsillar abscess
- - Infectious mononucleosis
- - Epiglottitis
- Foreign body
- - Blunt or penetrating airway injury
- - Upper airway burns (thermal and chemical)
- Hereditary angioedema
- Decreased oropharyngeal muscle tone
- Airway secretions or bleeding
- Vocal cord dysfunction
- Acute on chronic conditions
- EMERGENCY AIRWAY ASSESSMENT AND MANAGEMENT
- Rapid assessment of the airway and breathing
- Emergency airway management
- - Severe or complete obstruction
- Suspected foreign body
- No foreign body suspected
- - Conditions with progressive upper airway obstruction
- Physical examination
- - Signs of airway obstruction
- - Associated findings
- Ancillary studies
- - Imaging
- - Laboratory studies
- - Direct visualization
- Determining the cause of upper airway obstruction