29 - Upper airway emergencies

Summary

This chapter discusses the diagnosis, evaluation and management of upper airway emergencies. It presents special circumstances with regard to foreign bodies in the airway. The first step in the evaluation of the patient with suspected upper airway emergency is to determine the need for emergent intubation or surgical airway. If possible, a brief history should be obtained focusing on history of cancer, allergies, exposure to medications including ACE inhibitors, family history of C1 esterase inhibitor deficiency, trauma, and recent surgery. A targeted physical examination should include assessment for stridor, hoarseness, urticaria, edema of skin, lips, mouth, and throat. Given the high-risk, time-sensitive nature of these presentations, all practitioners should be familiar with their local resources, algorithms, and airway management options prior to seeing patients. In patients with a rapidly evolving upper airway obstruction, awake evaluation can provide invaluable information about potential complications before paralytics are administered.