Ear, nose & throat · UKMLA & AKT
Acute upper airway obstruction in children
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Stridor - harsh inspiratory noise; cardinal feature of upper airway obstruction
- Barking cough - characteristic of croup (subglottic oedema)
- Drooling - inability to swallow saliva; strongly suggests epiglottitis or retropharyngeal abscess
- Dysphonia/hoarse voice - laryngeal involvement (croup, epiglottitis)
- Increased work of breathing - subcostal/intercostal/suprasternal recession, nasal flaring, tracheal tug
- Cyanosis and altered consciousness - pre-terminal features; demand immediate action
Tripod position (sitting upright, leaning forward, jaw thrust) in a quiet, toxic, drooling child = epiglottitis until proved otherwise. Do NOT examine throat, cannulate, or distress the child - agitation can precipitate complete obstruction and arrest. Call anaesthetics and ENT immediately.
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