Airway Obstruction

A patient exhibiting stridor, an inability to swallow or holding a tripod position must be assessed urgently by a senior anaesthetist and otolaryngologist.

Adrenaline nebulisers (5ml 1 in 1,000) may help reduce swelling. Oxygen should be given if the patient is hypoxic. If the patient is old and calm enough that you believe you can cannulate them smoothly, then dexamethasone will also help reduce swelling.

Avoid unnecessary movement and painful procedures until senior anaesthetic and otolaryngology support is present.

Children exhibiting any of these symptoms should be left on a parent’s lap, while urgent senior support is organised.

Patients with signs of airway obstruction will frequently be taken directly to theatre for awake fibreoptic intubation, with a surgeon prepared to immediately perform a tracheostomy.

Learning bite

Patients with impending airway obstruction may present with a sore throat. A patient with stridor, inability to swallow or adopting a tripod position must be managed carefully, and with senior anaesthetic and otolaryngology support. Painful procedures may trigger complete airway obstruction.