Upper-airway obstruction and stridor

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Target exams

Red flags

• A child who is drooling, sitting forward in a tripod posture, refusing to lie down and looking toxic has epiglottitis or a supraglottic obstruction until proven otherwise — do not examine the throat, do not distress the child, and call for senior anaesthetic and ENT help to secure the airway in theatre
• A child with stridor whose chest becomes quiet, whose respiratory effort falls, who becomes drowsy or bradycardic is exhausting and heading for respiratory arrest — a silent chest in obstruction is a pre-terminal sign, not improvement
• A sudden choking episode in a well toddler followed by stridor or unilateral wheeze is an inhaled foreign body until proven otherwise — a normal chest radiograph does not exclude it
• A febrile, toxic child with rapidly worsening stridor who does not respond to nebulised adrenaline has bacterial tracheitis until proven otherwise and needs airway assessment, endoscopy and intravenous antibiotics

Life stages

Care settings

Clinical exam formats

Board mappings

• Upper-airway obstruction and stridor
• Upper-airway obstruction and stridor: localisation, causes and stepwise management
• Upper-airway obstruction and stridor: recognition, croup management and the critical airway
• Short case: the child with chronic stridor
• Long case: the child with recurrent upper-airway obstruction
• Upper-airway obstruction and stridor: causes, assessment and management
• Respiratory: the child with stridor
• Respiratory: upper-airway obstruction and stridor
• Patient Care: upper-airway obstruction and stridor in children
• Medical Expert: upper-airway obstruction and stridor