Airway obstruction can be subtle and is often poorly recognised.

Snoring, choking,
gurgling noises or stridor (harsh high pitched sound occurring on inspiration or
expiration), are signs of partial airway obstruction.

Complete airway obstruction will be silent as there will be no air movement.

Paradoxical see-saw movement of the abdomen and chest will occur due to
inspiratory effort against a closed airway. Normally, when you breathe, the chest
moves outwards, and synchronously the abdomen moves outwards due to the downward
movement of the diaphragm. In paradoxical breathing, the abdomen moves outwards as
the diaphragm moves downwards but the negative pressure generated against the
obstructed airway draws the chest inwards. This paradoxical pattern can occur with
increasing partial airway obstruction and is a sign that measures should be taken
to open the airway. Patients attempting to breathe against an obstruction may also
be using accessory muscles of breathing and there may be intercostal and subcostal
recession and a tracheal tug.

While a patient with a partial airway obstruction may be panicked and agitated,
beware the still patient whose chest is silent due to a completely obstructed
airway. Hypoxia due to airway obstruction is an ominous sign and signifies imminent
respiratory arrest.

NOISES ASSOCIATED WITH PARTIAL AIRWAY OBSTRUCTION:

Stridor: A harsh, high pitched noise occurring commonly on inspiration caused by

turbulent flow in the upper airway is suggestive of an upper airway obstruction.

Snoring:Occurs when the pharynx is partially obstructed by the soft palate or

tongue.

Gurgling: Occurs due to secretions or fluid (e.g. vomit) in the upper airway.

Choking:Choking occurs when there is a mechanical obstruction to airflow such as a

foreign body. Airway reflexes have to be present.

Hoarseness: Hoarseness is an abnormal deep, harsh voice generally caused by

irritation of, or injury to, the vocal cords.

Management : suction, remove foreign body, open airway (jaw thrust /head till chin
lift) give nebulizer if required.