Ear, nose & throat · UKMLA & AKT
Acute upper airway obstruction in children
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise acute upper airway obstruction in children — the full SA Note notes add investigations, management, complications and 10 practice questions.
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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