REMOVE AN UPPER AIRWAY OBSTRUCTION IN AN ADULT
RECOGNIZE COMMON CAUSES OF UPPER AIRWAY OBSTRUCTION
An object lodged in the airway of a casualty who is conscious can result in
unconsciousness, clinical death, and biological death. An airway obstruction can also
prevent proper ventilation of an unconscious casualty when rescue breathing or CPR is
being administered. Common causes of airway obstruction are discussed below.
a. Food. Food which is not swallowed properly can enter the trachea (part of
the respiratory system) instead of the esophagus (part of the digestive system). In
conscious adults, meat which has not been properly chewed is the most common food
obstruction. In small children, objects that can be treated like food (small buttons, for
example) are common causes of airway obstruction.
b. Vomitus. Stomach contents expelled during the act of vomiting are referred
to as vomitus. A casualty who inhales while vomitus is still in his mouth or pharynx can
cause the vomitus to enter the airway. Inhaling vomitus is a common cause of airway
obstruction in unconscious or semiconscious casualties. An elevated blood alcohol
level can contribute to this problem.
c. Blood Clots. Injuries to the head or facial areas (nose, cheeks, and so forth)
can cause blood clots to form in the mouth, nose, or nasal cavities. These clots can
become loose and be inhaled into the trachea. Obstructions caused by blood clots are
more likely to occur in unconscious casualties than in conscious casualties.
d. Tongue. The tongue can block the airway if the tongue muscles relax and
fall back into the pharynx. A relaxed tongue is the most common cause of airway
obstruction in unconscious casualties.
e. Other Objects. Other objects, such as dentures, can also result in blockage.
Objects lodged in the upper esophagus can also press against the trachea and reduce
the airflow through the trachea.
RECOGNIZE A PERSON IN RESPIRATORY DISTRESS
A casualty who is conscious and has an object lodged in his airway will begin to
cough or at least try to cough. He will probably have a distressed look on his face and
be clutching his throat. This clutching action is natural, but it has also been adopted as
the universal signal for choking (figure 5-1). Bluish coloration (cyanosis) of the lips,
interior of the mouth, and nail beds are indications of low oxygen content in the blood.
Any unconscious casualty should be examined to see if he is breathing. Even if the
casualty is breathing, perform periodic checks to make sure he is continuing to breathe.