An airway obstruction occurs when the passage for air to enter and exit the lungs is blocked, partially or completely. This hinders the free flow of air, essential for respiration. While some obstructions are minor, a severe airway obstruction is a life-threatening emergency. Prompt identification and intervention prevent serious complications like brain injury or cardiac arrest, which can occur quickly due to lack of oxygen.
Identifying the Critical Signs
Recognizing the signs of a severe airway obstruction is important, as they appear quickly. The universal choking sign, where an individual instinctively clutches their throat, is a common indicator. This gesture signals distress and an inability to breathe.
A person with a severe obstruction cannot speak, cry, or make effective sounds. Breathing attempts may be silent or involve gasping, with little to no air movement. An ineffective or absent cough is another sign, as the person cannot forcefully expel air to dislodge the blockage.
As oxygen deprivation progresses, skin color changes may occur. Cyanosis, a bluish discoloration of the lips, face, or fingernails, indicates a severe lack of oxygen. If the obstruction is not cleared promptly, the individual may lose consciousness. This signifies a dire emergency.
Distinguishing Severe from Partial Obstruction
Understanding the difference between severe and partial airway obstruction is important. With a partial obstruction, some air can still pass, allowing the person to cough forcefully, speak, or make sounds. Breathing may be difficult or noisy, producing wheezing or gasping sounds.
In contrast, a severe obstruction leaves the person unable to cough effectively, speak, or breathe. The hallmark of a severe blockage is often silence, as no air can pass to create sound. Unlike a partial obstruction where some air moves, a severe obstruction means the airway is nearly or completely blocked, preventing meaningful airflow. The absence of effective breathing, speech, or coughing indicates a complete blockage requiring immediate intervention.
Immediate Actions to Take
Upon recognizing severe airway obstruction, immediate action is necessary. If others are present, have someone call emergency services. If alone, begin first aid immediately, then call for help if the obstruction is not relieved.
For adults and children over one year old, a combination of back blows and abdominal thrusts (Heimlich maneuver) is used. To perform back blows, stand to the side and slightly behind the person, supporting their chest. Bend them forward and deliver five blows with the heel of your hand between their shoulder blades.
If back blows do not dislodge the object, proceed to five abdominal thrusts. Stand behind the person, wrap your arms around their waist, and make a fist. Place the thumb side of your fist just above their navel and below the rib cage, grasping it with your other hand. Deliver five inward and upward thrusts. Continue alternating between five back blows and five abdominal thrusts until the object is expelled or the person becomes unconscious.
For infants under one year, the approach involves back blows and chest thrusts. Pregnant or obese individuals require chest thrusts instead of abdominal thrusts.
When to Seek Emergency Medical Help
Calling for emergency medical help is important in any severe airway obstruction scenario. Contact emergency services immediately upon recognizing signs of a severe obstruction. Even if initial first aid is successful and the object dislodged, calling 911 is important for medical follow-up to check for internal injuries.
If the person becomes unconscious during the choking episode, summon emergency medical assistance immediately. If the obstruction is not relieved after initial first aid cycles, continue calling for help while alternating back blows and abdominal thrusts. For infants or children, contact emergency services if you are unsure of the cause or cannot clear the obstruction.