🚨 First step of resuscitation: Always ensure the airway is intact. Airway obstruction can be rapidly fatal, so recognition and immediate management are critical.

ℹ️ About

⏱️ Sudden onset: Foreign body aspiration, anaphylaxis.
🐢 Slow onset: Malignancy, inflammatory causes.
💨 Wheeze: Expiratory (lower airway).
🎵 Stridor: Inspiratory (upper airway).

Causes

Cause	Description	Management
🌬️ Asthma	Chronic inflammatory disorder, reversible obstruction with wheeze, SOB, cough.	Inhaled bronchodilators (salbutamol), corticosteroids, avoidance of triggers.
🚬 COPD	Irreversible airway obstruction (chronic bronchitis/emphysema), chronic cough, sputum, dyspnoea.	Bronchodilators, steroids, oxygen therapy, smoking cessation, rehab, vaccination.
🍎 Foreign Body Aspiration	Sudden cough, stridor, wheeze. Common in children/elderly.	Heimlich manoeuvre, bronchoscopy removal, oxygen support.
⚡ Anaphylaxis	Systemic allergic reaction with laryngeal oedema, wheeze, urticaria, hypotension.	IM adrenaline, airway support, antihistamines, steroids, monitor biphasic reaction.
🦴 Croup	Viral laryngotracheobronchitis in children: barking cough, stridor, hoarseness.	Humidified O₂, dexamethasone, nebulised adrenaline for severe cases.
🩸 Epiglottitis	Bacterial infection (H. influenzae B). Drooling, stridor, severe sore throat. 🚨 Emergency.	Controlled intubation, IV antibiotics (ceftriaxone), ICU monitoring.
🎗️ Lung Cancer	Airway obstruction via tumour invasion/compression. Cough, haemoptysis, wheeze.	Surgical resection, chemo/radiotherapy, stent, palliative care.
🛠️ Tracheal Stenosis	Narrowing from scarring, trauma, congenital cause. Stridor, recurrent infections.	Dilation, stenting, surgical resection, treat underlying cause.

Other Causes

🔹 Luminal: dentures, food bolus (“steakhouse”), fractured mandible, enlarged tongue (angioedema, bleeding), tumour, haemorrhage, mucus plug, trauma, bilateral vocal cord palsy.
🔹 Mural: oedema (trauma, anaphylaxis), haematoma (trauma, post-thyroid surgery), pus (abscess, epiglottitis), enlarged tonsils, laryngeal oedema/spasm, bronchospasm (asthma, mucus plug).
🔹 External compression: retropharyngeal abscess, goitre, obesity, neck haemorrhage.

🔬 Anatomy

🩺 Clinical Features

😰 Respiratory distress
💙 Cyanosis, shock
⛔ Risk of respiratory arrest

Basic Manoeuvres: Head tilt & chin lift

Adjuncts

👃 Nasopharyngeal airway
👄 Guedel airway
✂️ Front-of-neck access (emergency cricothyrotomy)

🛠️ Management Principles

👆 Suspected luminal obstruction: finger sweep if safe; leave dentures in place.
🫁 Choking algorithm: back blows → Heimlich (abdominal thrusts).
⚡ Anaphylaxis algorithm: IM adrenaline 0.5 mg, oxygen, IV access.
❤️‍🩹 If unconscious: check pulse & breathing → start CPR if absent.
Ensure airway: chin lift/jaw thrust, suction, O₂, recovery position.
Adjuncts: Guedel or nasopharyngeal airway if tolerated.
Failing oxygenation: Bag-valve-mask ventilation with 100% O₂, prepare for intubation.

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Acute Airway Obstruction