Presentation
These two cases are interesting because of their rarity and uncommon presentation. [ncbi.nlm.nih.gov]
However, early presentations, with symptoms of upper airway obstruction in childhood, have been reported [1]. The majority of cases present with obstructive symptoms. [academic.oup.com]
Entire Body System
- Unconsciousness
RECOGNIZE COMMON CAUSES OF UPPER AIRWAY OBSTRUCTION An object lodged in the airway of a casualty who is conscious can result in unconsciousness, clinical death, and biological death. [nursing411.org]
Continue alternating five back blows and five abdominal thrusts until successful or the patient becomes unconscious. In an unconscious patient: Lower the patient to the floor. Call an ambulance immediately. [patient.info]
If the patient becomes unconscious, support the patient carefully to the ground. Immediately call an ambulance and begin CPR. Feel for a carotid pulse and initiate chest compressions even if a pulse is present in the unconscious choking patient. [gponline.com]
Unconscious Victims [ edit ] Send a bystander to activate the Emergency Medical System if possible. [en.wikibooks.org]
- Asymptomatic
RESULTS: Viruses were detected in 70.9% of tonsils and 94.7% of adenoids, p CONCLUSIONS: Asymptomatic viral infections are common and directly related to the degree of airway obstruction significantly more often in adenoids than tonsils. [ncbi.nlm.nih.gov]
- Fever
*Internal Medicine Department, †Microbiology Department, 411 General Army Hospital, Tripoli, Greece [email protected] To the Editor: Infectious mononucleosis (IM) denotes a clinical syndrome characterized by systemic somatic complaints with prominent fever [journals.lww.com]
Other possible diagnoses Symptoms Possible Diagnosis High Fever Hyperextension of neck Dysphagia, pooling of secretions in throat epiglottitis retropharyngeal / peritonsillar abscess "Toxic" appearing child Markedly tender trachea bacterial tracheitis [rch.org.au]
An Adolescent Girl with Crohn’s Disease, Fever, and Sore Throat. Pediatric Annals, Vol. 44, Issue. 1, p. e14. CrossRef Google Scholar Pfleger, Andreas and Eber, Ernst 2013. Management of acute severe upper airway obstruction in children. [journals.cambridge.org]
Hospital 3 Eastbourne District General Hospital Correspondence to: K Tekeli kmt{at}doctors.org.uk A 22 year old man presented to the department of oral and maxillofacial surgery with a five day history of sore throat, pain on swallowing, and low grade fever [bmj.com]
- Foreign Body Aspiration
Our patient did have a history of eating peanuts the same day, despite this, his stridor and dyspnea were treated as a foreign body aspiration. However, the rapid onset of airway obstruction favored the diagnoses of foreign body aspiration. [casesjournal.biomedcentral.com]
[…] of foreign body aspiration. [emedicine.medscape.com]
Causes of upper airway obstruction include foreign body aspiration, blunt laryngotracheal trauma, penetrating laryngotracheal trauma, tonsillar hypertrophy, paralysis of the vocal cord or vocal fold, acute laryngotracheitis such as viral croup, bacterial [en.wikipedia.org]
Risk factors for foreign body aspiration in adults include diminished level of consciousness; impaired swallowing mechanism or diminished upper airway sensation as a result of neuromuscular disorder, prior cerebrovascular accident, or advanced age; and [accessmedicine.mhmedical.com]
Body Aspiration Sedation, sleep, medication effect leading to poor upper airway tone Figure 3: Laryngomalacia (noted dynamic inspiratory collapse) Figure 4: Epiglottitis as seen with laryngoscopy and classic "thumb sign" on lateral neck XR Figure 5: [learnpicu.com]
- Surgical Procedure
In the hands of an experienced bronchoscopist, aggressive endoscopic management does not preclude future surgical procedures if necessary. [bestpractice.bmj.com]
Surgical Treatment Options for Nasal Obstructions Several types of surgical procedures are used to correct or remove nasal obstructions: Endoscopic sinus surgery - This type of surgery is minimally invasive and can produce immediate results with very [midvalleyentallergyandhearing.com]
短句来源 Characteristic Appearance of Flow-Volume Curve in Intra-Thorax Upper Airway Obstrnction 胸内型上气道阻塞的流速容量曲线改变 短句来源 From June 1990 to December 1991,28 patients with obstructive diseases of the trachea and bronchus were treated with various surgical procedures [dict.cnki.net]
Respiratoric
- Cough
For the conscious patient with an apparent partial obstruction, encourage him or her to cough. NOTE: In cases where the patient has an apparent partial obstruction but cannot cough, begin to treat the patient as if this were a complete obstruction. [medical.tpub.com]
Children [ 3 ] If coughing effectively, just encourage the child to cough, and monitor continuously. If coughing is, or is becoming, ineffective, shout for help and assess the child's conscious level. [patient.info]
Management • If coughing effectively, just encourage the child to cough, and monitor continuously. • If coughing is, or is becoming, ineffective, shout for help and assess the child's conscious level. • If the child is conscious, give up to five back [slideshare.net]
- Stridor
As the plane gained elevation, the mass would grow and cause him to become stridorous and short of breath. The shortness of breath and stridor would only resolve upon landing of the plane. [ncbi.nlm.nih.gov]
Introduction Laryngomalacia is the most common congenital laryngeal anomaly and is the most frequent congenital cause of stridor in infants. [pedsinreview.aappublications.org]
When RA affects the cricoarytenoid joint, this may lead to acute stridor or dyspnoea, and potentially life-threatening complications. We report a case of RA patient with acute laryngeal stridor [ 1 ]. [omicsonline.org]
Inspiratory stridor and increased work of breathing are the hallmarks. [lifeinthefastlane.com]
- Respiratory Distress
Congenital laryngoceles are defined as cystic dilatation of laryngeal saccules and are an extremely rare cause of newborn respiratory distress. [ncbi.nlm.nih.gov]
- Dyspnea
D L CO% predicted was also the strongest correlate of dyspnea/̇VO 2 slope (r = -0.352, p = 0.005). [ncbi.nlm.nih.gov]
For example, when exertional dyspnea occurs, the airway diameter is likely to be reduced to about 8mm. Dyspnea at rest develops when the airway diameter reaches 5mm. [pulmonologyadvisor.com]
- Pharyngitis
Patients found to have a pharyngeal myofibroma should be managed with airway stabilization, surgical excision with preservation of speech and swallow function, and close postoperative monitoring for recurrence. [ncbi.nlm.nih.gov]
Contraindicated with CSF leaks/basilar skull fractures Oropharyngeal Tube: Used to assist bag mask ventilation when there may be poor pharyngeal tone or a large tongue leading to obstruction. [learnpicu.com]
Airway stenting, oropharyngeal: Oropharyngeal airway stenting mandibular block off pharyngeal wall 3. Hyperextension, head: Extreme hyperextension of head/neck causing upper airway obstruction in an infant. 4. [smartdraw.com]
Pharyngeal function was assessed by examining cough quality, palatal elevation, and presence or absence of pharyngeal sensation on recruitment to the study and on the second and third days after admission. [stroke.ahajournals.org]
Gastrointestinal
- Vomiting
Stomach contents expelled during the act of vomiting are referred to as vomitus. A casualty who inhales while vomitus is still in his mouth or pharynx can cause the vomitus to enter the airway. [nursing411.org]
Cannot be used in awake patients, as it causes them to gag and potentially vomit. [learnpicu.com]
Excessive salivation associated with choking, coughing, vomiting, and cyanosis starting with the onset of the feeding is the hallmark of tracheo–esophageal fistula [9]. [austinpublishinggroup.com]
Therefore, in addition to respiratory symptoms, the presence of hives, itching, flushing, nausea, vomiting, diarrhea, abdominal pain, dizziness, shock, and headache should suggest anaphylaxis; when these symptoms (especially skin involvement) are absent [pulmonologyadvisor.com]
- Abdominal Distension
In both cases, postmortem plain radiographs demonstrated gross abdominal distension with distortion and splaying of the rib cage. [ncbi.nlm.nih.gov]
- Abdominal Pain
Therefore, in addition to respiratory symptoms, the presence of hives, itching, flushing, nausea, vomiting, diarrhea, abdominal pain, dizziness, shock, and headache should suggest anaphylaxis; when these symptoms (especially skin involvement) are absent [pulmonologyadvisor.com]
- Nausea
Therefore, in addition to respiratory symptoms, the presence of hives, itching, flushing, nausea, vomiting, diarrhea, abdominal pain, dizziness, shock, and headache should suggest anaphylaxis; when these symptoms (especially skin involvement) are absent [pulmonologyadvisor.com]
Cardiovascular
- Cyanosis
Intubation was attempted several times in one patient with cyanosis, but is unsuccessful; cricothyroidotomy was performed in this patient and pumping in the small muscular arterial branches was confirmed in the operating room. [ncbi.nlm.nih.gov]
Partial Airway Obstruction The signs of partial airway obstruction include unusual breath sounds, skin discoloration (cyanosis), or changes in breathing pattern. [medical.tpub.com]
Croup score 0 1 2 Stridor None Inspiratory Inspiratory and expiratory Air entry Normal Decreased Minimal absent Retractions None Suprasternal minimal Suprasternal, sternal, subcoastal Color Normal Cyanosis in room air Cyanosis with 40% of oxygen Consciousne [slideshare.net]
Cyanosis and diminishing conscious level (particularly in children). The victim being unconscious. Epidemiology Incidence Choking is a risk whenever food is consumed. [patient.info]
- Heart Failure
The fetus should be followed closely for early signs of hydrops (in utero heart failure). [cincinnatichildrens.org]
Overdistention of the lungs can put pressure on the heart and effect the heart’s ability to function. If the heart cannot beat effectively hydrops (congestive heart failure) can occur. The cause of CHAOS is currently unknown. [fetus.ucsf.edu]
This can put pressure on the heart and affect its function. If the heart can't beat effectively, congestive heart failure can occur. The cause of CHAOS is currently unknown. It is a very rare condition and is not thought to recur in families. [ucsfbenioffchildrens.org]
Signs of right-sided heart failure, such as hepatic congestion and ankle edema, may appear. In addition, airway narrowing often coincides with the appearance of stridor. Beware: there are other diseases that can mimic an upper airway obstruction. [pulmonologyadvisor.com]
- Tachycardia
Arterial desaturation is a late manifestation; better indicators of severity include stridor, poor air movement, accessory muscle use, abnormal mentation or agitation, tachycardia, hypertension, and pulsus paradoxus. [accessmedicine.mhmedical.com]
On examination, he looked unwell with tachycardia (120 beats/min) and a temperature of 37.2ºC. He was normotensive and mildly tachypnoeic (22 breaths/min). [bmj.com]
Signs of hypoxemia are also present Anxiety Restlessness Tachycardia Pallor Cyanosis (late sign) Quan L. Diagnosis and treatment of croup. Am Fam Physician. 92419;6:747-55. 23. [slideshare.net]
[…] thought to be due to resumption of respiration with arousal. 13,45 During obstructive apnea, episodes of bradycardia 14 and occasionally heart block have been reported, 46 and cardiac output can decrease by up to one third. 15 At apnea termination, tachycardia [stroke.ahajournals.org]
Jaw & Teeth
- Halitosis
Four (0.7%) died within 24 hours of the procedure, while the major morbidities were halitosis (n = 41, 6.7%) and iatrogenic pneumonia (n = 24, 3.9%). [ncbi.nlm.nih.gov]
Skin
- Sweating
He denies hemoptysis, fevers, chills, or night sweats. There is no history of lung cancer in his parents or siblings. [clevelandclinicmeded.com]
Musculoskeletal
- Muscle Spasm
Dyspnea is caused by intermittent glottic and subglottic obstruction that arises from both laryngeal and supra-laryngeal/pharyngeal muscle spasms. [pulmonologyadvisor.com]
Fetus
- Hydrops Fetalis
All of the patients presented in the second trimester and all had hydrops fetalis. Three cases had bilateral hyperinflated lungs, midline shift of heart, flattening or inversion of the diaphragm, and fetal ascites. [ncbi.nlm.nih.gov]
When the blockage is complete, the lungs can become hugely overdistended and can lead to hydrops fetalis (congestive heart failure); In order to determine the severity of the problem a number of tests are recommended. [fetus.ucsf.edu]
Face, Head & Neck
- Facial Edema
Two patients with inspiratory stridor, anterior neck swelling, and facial edema progressed to respiratory distress and their hematomas were removed by surgery, during which, sustained superficial venous bleeding was confirmed. [ncbi.nlm.nih.gov]
Neurologic
- Agitation
There is often agitation in the early stages. Other signs include labored, ineffective breathing, until the person is no longer breathing (apneic). Loss of consciousness occurs if the obstruction is not relieved. [medicinenet.com]
Arterial desaturation is a late manifestation; better indicators of severity include stridor, poor air movement, accessory muscle use, abnormal mentation or agitation, tachycardia, hypertension, and pulsus paradoxus. [accessmedicine.mhmedical.com]
The ENT surgeons attempted an awake tracheostomy, but this was difficult due to her being agitated and unable to lie still, and a calcified trachea. [bjmp.org]
Symptoms and signs – Not all may be present Partial airway obstruction: breathing laboured, gasping or noisy some air escaping from the mouth patient coughing or making a ‘crowing’ noise extreme anxiety or agitation Total airway obstruction: the person [stjohn.org.nz]
- Somnolence
In this patient, supraglottoplasty was performed to remove the redundant tissue, resulting in a moderate improvement in daytime somnolence on follow-up several weeks later. [nejm.org]
A 55-year-old male patient with the complaints of high body temperature despite the usage of intravenous antibiotics, somnolence, increased difficulty in breathing, and swelling in the neck was diagnosed with Ludwig angina and abscess was urgently drained [go.gale.com]
Daytime somnolence may be a prominent feature of upper airway obstruction Quan L. Diagnosis and treatment of croup. [slideshare.net]
Therefore, daytime somnolence may be a prominent feature of upper airway obstruction. In severely affected patients with chronic upper airway obstruction, cor pulmonale may occur as a result of chronic hypoxemia and hypercarbic respiratory failure. [pulmonologyadvisor.com]
- Headache
Definition Mediastinal masses present special anesthetic considerations, as they can be associated with hemodynamic compromise from pulmonary artery and cardiac compression, neurologic problems (increased ICP, headache, and altered mental status) from [openanesthesia.org]
These include the following: dental malocclusions, TMJ joint disorders, distorted faces, obstructive sleep apnea in children and adults, bed wetting, migraine like headaches, neck and back pain, lower IQ, stunted growth, criminal behavior tendencies, [massagetoday.com]
Therefore, in addition to respiratory symptoms, the presence of hives, itching, flushing, nausea, vomiting, diarrhea, abdominal pain, dizziness, shock, and headache should suggest anaphylaxis; when these symptoms (especially skin involvement) are absent [pulmonologyadvisor.com]
- Lethargy
Your symptoms may be subtle, such as decreased activity, or lethargy. Your symptoms may also vary from mild to severe from one asthma attack to the next. [webmd.com]
- Seizure
[…] and improperly chewed other food. [ 7 ] Differential diagnosis Rapid evaluation is key: swiftly consider other conditions that may cause sudden respiratory distress, cyanosis or loss of consciousness, such as: Anaphylaxis Syncope Myocardial infarct Seizure [patient.info]
Workup
Depending on the results of your examination, you may require further workup in the form of scans, blood work or biopsies. Many different treatment options are available depending upon your diagnosis. [hopkinsmedicine.org]
Septic workup should likely include a chest X-ray, labs including lactate, VBG, and blood cultures. Get your “double set up” airway equipment to the bedside. [emergencymedicinecases.com]
Hypoxemia upon exercise has been reported in a series of seven patients secondary to alveolar hypoventilation. 6 Exertional hypoxemia in a patient with a normal diffusion capacity is reflective of alveolar hypoventilation that calls for further workup [rtmagazine.com]
• Investigations add little in the initial workup • As viral croup is the commonest cause of UAO, attempts to identify other causes is also very important to confirm the diagnosis. 16. [slideshare.net]
X-Ray
- Atelectasis
J Emerg Nurs. 2004; 30: 473-474. http://www.mayoclinic.com/health/atelectasis/ DS01170/ DSECTION Amy Madsen. Managing Mucus Plugs. [austinpublishinggroup.com]
CXR may show an opacity that requires removal at bronchoscopy or atelectasis. [patient.info]
[…] indications for mechanical ventilation include presence of hypoxia and/or hypercapnia (PaO_ 2 <60 mmHg, PaCO_ 2 >55 mmHg), associated severe trauma with unconsciousness and/or shock state, bilateral flail chest and presence of airway obstruction or repeated atelectasis [dict.cnki.net]
Asymptomatic phase - Subsequent lodging of the object with relaxation of reflexes that often results in a reduction or cessation of symptoms, lasting hours to weeks Complications phase - Foreign body producing erosion or obstruction leading to pneumonia, atelectasis [emedicine.medscape.com]
Treatment
AP2, prior to FP treatment, was enriched with Streptococcus pneumoniae. [ncbi.nlm.nih.gov]
Prognosis
Laryngeal atresia is an extremely rare fetal anomaly with dismal prognosis. It is important to differentiate the condition from other lesions with a more favorable prognosis, such as congenital adenomatoid malformation of the lung. [ncbi.nlm.nih.gov]
Overall prognosis is considered considered generally poor 6. tracheal atresia Promoted articles (advertising) [radiopaedia.org]
Etiology
Lower airway obstruction => COPD, asthma, bronchiectasis, bronchomalacia, infectious etiologies (pneumonia, TB), foreign bodies, malignancies, etc. [emdocs.net]
The purpose of this retrospective review of a prospective database was to investigate etiologic factors related to the development of AAO due to postoperative hematoma after ACF and formulate appropriate prevention and treatment guidelines. [ncbi.nlm.nih.gov]
The role of function in the etiology and treatment of malocclusion. Am J Orthod, 1979;54:883-98. Linder-Aaronson S, Woodside DG. Excess Face Height Malocclusion: Etiology, Diagnosis and Treatment. Chicago: Quintessence Publishing Co., 2000. [massagetoday.com]
The clinical data of 98 cases of acute massive hemoptysis were analysed with the stress on its etiology and treatment. The etiological analysis of this series revealed that tuberculosis was the most common cause (57.2%). [dict.cnki.net]
Epidemiology
KEYWORDS: COPD epidemiology; Clinical Epidemiology; Paediatric Lung Disaese [ncbi.nlm.nih.gov]
Navbar Search Filter Mobile Microsite Search Term Article navigation 1 Department of Epidemiology, Johns Hopkins University School of Hygiene and Public HealthBaltimore, MD Search for other works by this author on: ALFREDO MORABIA 1 Department of Epidemiology [academic.oup.com]
He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education. [lifeinthefastlane.com]
Pathophysiology
Spirometry is an easy method to measure lung function and to show pathophysiology. [ncbi.nlm.nih.gov]
See Figure 2 for a comparison of what 1 mm of circumferential edema does in terms of airway resistance to an infant and an adult Pathophysiology Upper airway obstruction can occur for a variety of causes, but fundamentally, leads to increased airway resistance [learnpicu.com]
Multimodal approach to control postoperative pathophysiology and rehabilitation[J]. Br J Anaesth, 1997, 78 (5): 606- 617. doi: 10.1093/bja/78.5.606 2 Loop T. Fast track in thoracic surgery and anaesthesia: update of concepts[J]. [yxbwk.njournal.sdu.edu.cn]
Pathophysiology After foreign body aspiration occurs, the foreign body can settle into 3 anatomic sites, the larynx, trachea, or bronchus. Of aspirated foreign bodies, 80-90% become lodged in the bronchi. [emedicine.medscape.com]
Prevention
The safety of high pressure source ventilation (jet ventilation) is dependent upon upper airway patency to facilitate adequate passive expiration and prevent increasing intrathoracic pressure and its associated deleterious sequelae. [ncbi.nlm.nih.gov]
Prevention is highly emphasized here because once an airway becomes obstructed, we have a very short time to deal with this life threatening emergency. We work all the time with techniques and vigilence to prevent this. [erikrichmond.com]
How can it be prevented? How can I tell if my child is choking? How is it treated? What is airway obstruction? Airway obstruction is when something prevents air from reaching the lungs and the brain. [virtualpediatrichospital.org]