| ID | 86 |
|---|---|
| Name | ACUTE LARYNGEAL OBSTRUCTION |
| Cause | Causes: 1. Traumatic- a. Strangulation b. Laceration c. Inhaled foreign bodies d. Burns e. Irritant gases. 2. Inflammatory- a. Acute epiglottitis b. Laryngo-trachio-bronchitis 3. Diphtheria 4. Angioneurotic oedema 5. Tumours |
| Signs Symptoms | |
| Diagnosis | Acute laryngeal obstruction is a life-threatening emergency and if it is total and unrelieved, the patient will die in about 3 minutes. Partial obstruction with stridor, cyanosis and a hoarse voice is dangerous and an urgent treatment is necessary to prevent death. In total obstruction speech is impossible. |
| Investigations | |
| Management | Managements: 1. Establish a better air way. 2. Administer O2; Heliox mixture (if available) is more effective. 3. Removal of foreign body obstruction: a. Foreign body obstruction is more common in children, in that case it can often be removed by turning the patient head downwards and squeezing the chest vigorously. In adults this mechanism is usually not applicable, but a sudden and forceful compression of the upper abdomen may be effective (Heimlich manoeuvre). b. In cases where manual trials are failed, and the foreign body is unknown, direct laryngoscopic investigation and removal is best tried. 4. Tracheostomy: If the above procedures fail to relieve obstruction, and/or, if the patient continues to deteriorate with deepening cyanosis and increasing pulse rate, an emergency tracheostomy should be done. 5. Treatment of the cause: a. If the cause of obstruction is throat infection, appropriate antibiotic treatment should be given, b. In case of diphtheria- diphtheric antitoxin should be administered immediately, c. In angioneurotic oedema or post radiotherapy oedema, obstruction can be prevented or reduced by hydrocortisone 200mg i.v, adrenaline (1:1000) 0.5-1ml i.m and chlorpheniramine maleate 10-20mg by slow i.v injection. |
| Introduction | Acute laryngeal obstruction is a life-threatening emergency and if it is total and unrelieved, the patient will die in about 3 minutes. Partial obstruction with stridor, cyanosis and a hoarse voice is dangerous and an urgent treatment is necessary to prevent death. In total obstruction speech is impossible. |
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