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  • Print publication year: 2013
  • Online publication date: September 2013

Chapter 137 - Acute airway emergencies

from Section 25 - Otolaryngologic Surgery


Acute airway distress is a medical emergency that requires immediate treatment to limit morbidity and mortality. Airway distress arises from any process in the larynx, trachea, or bronchi that obstructs pulmonary ventilation. A wide variety of pathologic processes can result in airway distress. Management of patients experiencing acute airway distress depends greatly on the severity of distress as well as the specific etiology, but restoring adequate ventilation to the pulmonary system is the goal of all treatments. Oxygen administration, intubation, cricothyrotomy, and tracheotomy are all treatment options for patients in acute airway distress.

Differential diagnosis

Since the treatment of acute airway distress can depend greatly on the etiology of the problem, it is important to know the clinical presentation of different causes of airway distress. Interpreting both patients' presenting signs and symptoms in conjunction with physical examination, laryngoscopy when appropriate, and ancillary testing is essential to determine the etiology of obstruction and proper management. Causes of acute airway obstruction include infections, immunologic reactions, trauma, and foreign body obstruction.

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Further reading
Al-Qudah, M, Shetty, S, Alomari, M, Alqdah, M . Acute adult supraglottitis: current management and treatment. South Med J 2010; 103(8): 800–4.
Hwang, SY, Yeak, SC.Management dilemmas in laryngeal trauma. J Laryngol Otol 2004; 118(5): 325–8.
Rosbe Kristina, W.Foreign bodies. In Lalwani, , AK, ed. Current Diagnosis & Treatment in Otolaryngology – Head & Neck Surgery. 2nd edn. New York, NY: McGraw-Hill Medical; 2007.
Shockley, WW.Ludwig angina: a review of current airway management. Arch Otolaryngol Head Neck Surg 1999; 125(5): 600.
Temiño, VM, Peebles, RS. The spectrum and treatment of angioedema. Am J Med 2008; 121(4): 282–6.