First of all, it should be noted what is airway obstruction. This is the name of the syndrome of obstruction of the respiratory tract of a person. Such a process can be observed in any part of the upper respiratory tract.
Causes
Obstructive respiratory syndrome can occur for the following reasons:
- diseases in acute and chronic form;
- getting into the bodies of foreign bodies;
- anaphylaxis - excessively hypersensitivity;
- upper respiratory injuries.
Despite the exact cause of airway obstruction in children and adults, this disease is a rather dangerous complication, which is characterized by increasing hypoxia. The most common cause of asphyxiation, in case of poisoning with sedatives or fainting, is called tongue retraction.
An equally common cause of possible obstruction is spasm and swelling of the vocal cords. This type of obstruction can cause bleeding and burns, while in children this condition can occur after infectious diseases.
Types of injuries
Once you know what airway obstruction is, you should become familiar with the types of injuries.
Internal:
- burns by flame;
- complications after intubation;
- inhalation of toxic toxic fumes.
Intubation involves the insertion of a tube into the throat, which will help keep its passage open, to be able to administer drugs, or to carry out the necessary analysis. In case of trauma during tracheal intubation, the patient usually has edema or paralysis of the vocal cords or spasm, hematoma in the mucous tissue, displacement of the laryngeal cartilage, damage to the epiglottis.
These complications can develop due to improperly performed intubation: frequent attempts at execution or rough manipulation. The reason for insufficient patency in the respiratory organs can also be a surgical operation on these organs.
With a burn of the respiratory tract, the patient may have erythema of the mouth, panting with a whistle. When inhaling toxic odors, pneumonia and toxic type edema can also join the edema of this type. With the onset of the early stage of the disease, a person may even die from a lack of oxygen due to gas poisoning.
Outside:
- blunt (external blow);
- penetrating (gunshot or stab wounds).
It is noteworthy that the obstruction can cause displacement of the cartilage located in the larynx, swelling of its tissues, as well as the narrowing of the VDP, which is caused by hematoma. Often, obstruction is caused by bleeding in the respiratory system.
Causes of bleeding
Bleeding is sometimes caused by the following reasons:
- complication after operations (tracheostomy, tonsillectomy, as well as surgery in the head);
- trauma of internal or external type;
- unexpected, causeless bleeding from the mouth and nose.
In particular, the development of bleeding in the airborne diseases is dangerous if the patient does not have the ability to cough.
Tracheostomy
If bleeding is complicated, the patient should be brought to a drainage position, the mouth and throat should be cleaned, and the trachea should be intubated thoroughly. After that, the bleeding is finally stopped, making a plasma transfusion, controlling blood coagulation, as well as performing surgery.
A tracheostomy is an urgent operation, which consists in the introduction of a tube into the trachea using an incision made in front of the neck. Tracheostomy is allowed to be used for various injuries of the larynx, asphyxia, as well as other conditions that are caused by diphtheria or false croup, and foreign bodies that have fallen into the larynx.
The suction of foreign inclusions is performed not only in adults, but also in children under four years of age. A foreign body usually enters the larynx, bronchi, or trachea. In infants, this inclusion can cause obstruction of the lower laryngeal lumen.
Extraneous aspiration in adults usually occurs when eating. This is especially noted when drinking alcohol, because at this time the protective reflexes of the airborne diseases are reduced. The ingestion of any body after some time can cause a very strong bronchus and laryngospasm, which can be fatal.
A foreign body stuck in the throat can stoke the entrance, causing apnea, aphonia, and cyanosis. This condition of a person can be mistaken for a heart attack. If partial obstruction is detected, the patient may experience shortness of breath, as well as a suffocating cough.
First aid for obstruction of the respiratory tract with a foreign body is to immediately call a doctor. Before his arrival, use the Pinocchio technique: head down on the patient’s feet, tap on the back with reinforcement, and if the stuck object comes out, carefully remove it from the throat.
If the victim is conscious, he can be slightly struck on the back to remove the foreign body. In case of impaired consciousness, blows are usually made on the back. If the extraneous inclusion cannot be removed, and it is difficult to perform laryngoscopy, a tracheostomy is performed, and then it is removed surgically or endoscopically.
Diseases that cause pathology
The main ailments that can pose a great risk of obstruction include the following:
- Retropharyngeal abscess caused by aerobic or anaerobic microflora, or staphylococcus.
- Ludwig's sore throat is a necrotic phlegmon of the mouth.
- Viral croup is usually detected in newborns, as well as in children under three years of age. Signs of a narrowing of the airways usually disturb the person at the beginning of the illness.
- Bacterial croup in most cases occurs in children older than two years, or in adults. In a severe case, the patient may experience an acute onset of croup, which affects the epiglottis, arytenoid cartilage, and also the ligamentous structures.
- Angioedema pathological edema may be allergic in nature, or may be hereditary. The last type of edema is characterized by sporadic edema, which can pass to the intestinal wall, genitals, arms and legs, larynx, and also the face. Strong pain in the peritoneum may also be noted.
All diagnostics are carried out based on the cause of the disease. It includes x-rays and computed tomography, and can not do without interviewing people who accompany the patient.
Treatment
Treatment of the causes and signs of airway obstruction consists in surgical drainage of wound surfaces, as well as taking antibiotics. To maintain patency of the upper respiratory tract, a nasotracheal intubation is performed on the patient.
Initially, the patient is administered high doses of the drug "Penicillin", and surgical treatment is performed. To maintain the patency of the VDT, a tracheostomy, cricothyroidotomy and orotracheal intubation are done.
With viral croup, doctors recommend aerosol inhalation, and in case of acute respiratory failure, tracheal intubation is indicated. There is no particular need to perform a tracheostomy.
Therapy for angioedema consists of tracheal intubation, or tracheostomy. To relieve abdominal pain, the patient is prescribed analgesics. To prevent an attack, you can prescribe aminocaproic acid, as well as androgens, doctors should help maintain an adequate intravascular volume through the use of adrenaline.
Angioedema
Angioedema against the background of an allergy can occur in a patient due to an antigen reaction. In addition, it may be accompanied by rhinitis or asthma. Patency in the bronchi and trachea over time may be troublesome for the following reasons:
- diseases of the bronchi and trachea;
- squeezing from the outside (goiter, mediastinal bleeding);
- injuries.
Vomiting is usually aspirated during anesthesia, coma, and oppression of the nervous system, as well as during intoxication with strong alcohol, when the patient’s mechanism of natural coughing is disturbed for a reason. If food enters the respiratory tract, a person may develop reactive edema.
Strong acidity
If a person has an increased acidity of the juice in the stomach, toxic edema of the respiratory organs may join reactive edema during aspiration. Clinically, this can be manifested by a drop in pressure, persistent bronchus and laryngospasm, cyanosis, as well as increasing asphyxia.
To help the patient, he is given a drainage position, the head is lowered, and the oropharynx is cleaned in an accessible way. Next, aspiration and intubation of the bronchi and trachea should be performed, and obstructive syndrome should be eliminated very quickly. If spontaneous breathing is not achieved, the patient is usually given mechanical ventilation.
Blood aspiration
Aspiration of blood in the VDP can be dangerous, especially if the cough mechanism is impaired. Excessive amounts of blood can be ejected during tracheostomy from the vessels of the bronchi, nose and mouth, with hemostasis failure. Some blood in the bronchioles may begin to coagulate.
With the consciousness preserved during bleeding, the optimal variant of tamponade is produced, and they also carefully monitor the patient. With persistent aspiration syndrome, and lack of consciousness, the patient is given a position in which breathing can be drained.
To perform therapy, it is necessary to quickly cleanse the mouth and throat, intubate the trachea, restore the patency of the bronchi, using a suction for this. Massive aspiration can cause severe hypoxia due to complete breathing. Bronchospasm and laryngospasm occur even in the case of moderate aspiration of the fluid.
Common types of drowning:
- asphyxial (lack of fluid in the lungs, the presence of a skull injury);
- true (the presence of fluid in the lungs and stomach);
- shinkope.
In case of fainting and oxygen deficiency, it is necessary to call the doctor and clean the patient’s mouth, throat and throat well. After this, the patient is placed on his knee down with his stomach, in such a position that the head is below the level of the chest, and then slightly pressed into place between the shoulder blades to push excess water out of the bronchi. After this, the patient is laid to one side and the VDP is cleaned well.
Obstruction in infants
It is also worth saying what is airway obstruction in infants. In newborns, it develops in most cases after birth, and it is usually due to the fact that an alien inclusion enters the upper respiratory tract. Most often they are removed by suction.
In children, this condition is most often caused by:
- epiglottide;
- bacterial tracheitis;
- viral croup.
In newborns, obstructive syndrome can be caused by prolapse of the vocal fold, which is traumatic in nature, for example, due to complex births or improperly performed intubation.
The next type of respiratory failure is called intramural obstruction, which is usually caused by the diaphragm, hematoma, subglottic stenosis, laryngeal membrane. When the intubation process is complete, there is a risk of a stridor.
In addition, this complex condition can occur when the respiratory organs are compressed from the outside: estramural obstruction develops, which occurs as a result of cystic hydroma or goiter of blood vessels.
Total
So what is airway obstruction (upper)? It is a rather dangerous pathology that requires urgent medical attention. It is important to do everything on time so as not to lead to even more dangerous complications.