Sputum congestion is often caused by severe pulmonary infections in children with thick sputum and reduced sputum expectoration. Urgent clinical management is needed to avoid oxygen deprivation, asphyxia, or even death of the child. The patient should be immediately aspirated orally and nasally to remove the sputum and relieve the airway obstruction caused by sputum blockage. At the same time, the child can be given oxygen to correct hypoxemia and improve tissue oxygenation. If necessary, the child may be given a fiberoptic bronchoscope to perform microscopic aspiration and clear the airway. Alternatively, the child may be intubated, an artificial airway established, and endotracheal suctioning performed. Systematic treatment should be given for these conditions caused by the primary disease. Along with anti-infective treatment, the child may be given phlegmolytic drugs and appropriate rehydration to dilute the sputum and reduce sputum congestion. In addition, the child should be given appropriate back patting during daily care to promote the coughing up of sputum and reduce the occurrence of obstructive pneumonia, obstructive atelectasis and airway obstruction caused by sputum accumulation.