Tongue-Related Airway Obstruction
A relaxed tongue is the most common cause of upper airway obstruction in patients who are unconscious or who have suffered spinal cord or other neurological injuries. The tongue may relax into the airway, causing an obstruction. In some cases, other injuries complicate this phenomenon. For example, a patient who is unconscious following a blow to the head may also have suffered upper airway trauma, causing both the tongue and the trauma to block the airway.

Foreign Body/Choking
The most common cause of airway obstruction in children is a foreign body lodged in the airway. Choking can fully or completely obstruct the airway. Small toys, round foods such as berries and grapes, rocks, pebbles, and other enticing objects are common culprits. 88 percent of airway obstruction deaths occur in children younger than age 4, highlighting the need for vigilance about children’s access to small objects and breakable toys.

Swelling
Swelling can obstruct the airway in a matter of seconds. Though infections can cause severe upper airway swelling, the most common cause is anaphylaxis. Anyone with an allergy can have an anaphylactic reaction, even if they have been previously exposed to the allergen without such an extreme reaction. More than 32 million Americans have food allergies, putting millions at risk of swelling-related airway obstructions. Moreover, the prevalence of food allergies is increasing, with the rate of peanut allergies in children tripling between 1997 and 2008.

Asthma may also cause upper airway swelling. In most cases, asthma is well-managed with a rescue inhaler, but severe asthmatic reactions can be fatal. Twenty-six million Americans have asthma. Worldwide, at least 250,000 people die prematurely from asthma, but prompt medical care and diligent airway management has greatly reduced mortality in the U.S.

Infection
Infections such as pneumonia, RSV, and even colds may obstruct the upper airway. Children are more vulnerable because of their smaller airways. In newborns, upper airway obstructions, even partial ones, are particularly dangerous because newborns breathe through the nose. People with chronic respiratory diseases such as COPD also face a higher risk of infectious upper airway obstructions.

Trauma
Traumatic injuries can directly obstruct the airway, such as when a gunshot or knife wound collapses portions of the airway. Trauma can also cause continuous bleeding or vomiting that obstructs the airway, making airway management difficult and increasing the risk of aspiration pneumonia.

Traumatic brain and spinal cord injuries may also lead to upper airway obstruction. If a patient cannot clear their own airway, they may require suctioning. In some cases, brain and spinal cord injuries inhibit the brain’s ability to control breathing, coughing, and other important respiratory functions.