Airway Obstruction

Airway obstruction is anything that blocks the flow of air into and out of your lungs. This could be anything from swelling and mucus to abnormal growths or foreign objects blocking your airways.

Airway obstruction can come on over time or only happen under certain circumstances. You might not notice symptoms until you’re having difficulty breathing. It can also happen all at once, like if something is stuck in your windpipe or if you’re having an allergic reaction. Call 911 (or your emergency service number) or get emergency medical attention if you’re having trouble breathing or swallowing.

What are the types of airway obstruction?

Obstructions can happen in your upper or lower airways. The three main types of airway obstruction include:

• Foreign body obstruction: This could be things like food or a small household item stuck in your airways.
• Dynamic obstruction: This is a type of blockage caused by conditions that might come and go at different times, like swelling (inflammation) from chronic lung disease.
• Static obstruction: This means something is blocking your airway that won’t get better on its own. Examples include tumors or differences in your airways that you’re born with.

What are the symptoms of airway obstruction?

Airway obstruction symptoms include:

• Difficulty breathing or speaking
• Noises when you breathe, like wheezing or whistling (stridor)
• Shortness of breath (dyspnea)
• Skin color changes — like bluish skin, lips or fingernails if you have lighter skin, or gray or white lips and gums if you have darker skin (cyanosis)
• Behavior changes, like agitation or confusion
• Daytime sleepiness

What causes airway obstruction?

Body tissue, objects and structural changes can block your airway and make it hard to breathe. Causes of airway blockages can include:

• Foreign objects: Food or foreign objects (like small toys or household items) can get stuck in your airways — or get stuck in your esophagus and push into your windpipe.
• Abnormal growths: Cancerous tumors, noncancerous growths and granulomas can block your airways from the inside or push into them from the outside.
• Trauma: Injuries, burns and medical procedures (like intubation) can damage your airways and narrow them.
• Swelling and inflammation: Allergic reactions and infections can cause your airways to swell.
• Obstructive airway conditions: These include COPD (chronic obstructive pulmonary disease) and asthma.
• Structural or functional differences: Differences in your airways or how they work can block your airways. Examples include bronchomalacia and vocal cord paralysis.
• Thick mucus: Conditions like cystic fibrosis can create thick mucus that gets stuck in your airways.

What are the risk factors for airway obstruction?

Anything that makes it easier for food or other substances to go down the wrong way (aspiration) can put you at a higher risk for airway obstruction. These include medications that make you calm or sleepy, airway differences and nervous system disorders. Any condition that can cause swelling or growths can also put you at a higher risk.

What are the complications of airway obstruction?

Airway obstruction can be dangerous because it can block your ability to breathe. A person can die if they go too long without oxygen.

How is airway obstruction diagnosed?

Healthcare providers diagnose airway obstruction based on your symptoms and a physical exam. They may also use tests and imaging to determine the cause. These include:

• Bronchoscopy to look inside your airways and remove obstructions
• Pulmonary function tests to measure how well you’re breathing
• Chest X-rays and CT scans to get images of the inside of your airways

How is airway obstruction treated?

Treatment for airway obstruction depends on the cause. A bronchoscopy can help with diagnosis and treatment, but additional treatments include:

• Heimlich maneuver: This can force food or a foreign object out of your throat or airways.
• Surgery: This removes a blockage.
• Intubation: A provider may need to open your airways with a tube that goes down your throat and into your windpipe. Providers usually use a ventilator to breathe for you when you’re intubated.
• Tracheostomy (trach): A tracheostomy creates an opening in your airways so you can breathe. This can be temporary or permanent.
• Epinephrine: This treats swelling from anaphylaxis.
• Corticosteroids or bronchodilators: These medications reduce inflammation.

You may need ongoing treatments for health conditions that can lead to airway obstruction, such as:

• Medications that fight infections: Antivirals, antibiotics and antifungals are good examples.
• Medications that block inflammation: These include antihistamines and leukotriene modifiers.
• Inhalers: Your provider might recommend a daily inhaled bronchodilator and/or steroid. You might also have a fast-acting rescue inhaler for when you need immediate relief.

When should I see my healthcare provider?

Talk to your healthcare provider if you notice symptoms of airway obstruction. These might include feeling short of breath more easily or having daytime sleepiness disrupt your day (despite enough sleep).

When should I go to the ER?

Go to the emergency room, call 911 (or your local emergency service number) or get help from someone nearby right away if you suddenly can’t breathe or swallow.

Can airway obstruction be prevented?

The best way to reduce your risk of airway obstructions is to manage any ongoing health conditions that can cause them. You should also always chew your food well and eat and drink while sitting up. Never let kids put toys with small parts in their mouths. And follow their healthcare providers’ recommendations for what kind of foods are safe to eat.