OVERVIEW
OVERVIEW
Respiratory obstruction is a narrowing or blockage of any part of the respiratory tract that prevents gas exchange, resulting in obstructive dyspnea.
Insured or not
Yes
Department of Medicine
Otorhinolaryngology, Respiratory Medicine
Clinical Symptoms
Dyspnea, chest and abdominal paradoxical breathing, inspiratory wheezing, etc.
Hazard
It can lead to acute respiratory failure, which is life-threatening.
Examination
X-ray film, CT, laryngoscopy, bronchoscopy, etc.
Diagnosis
Diagnosis is based on the manifestations of dyspnea and inspiratory stridor, combined with X-ray examination.
Treatment principle
Keep the airway open, quickly relieve dyspnea, and give symptomatic treatment.
Curability
Prognosis can be improved by active treatment.
Dietary advice
Fasting in the acute stage, give liquid, easy-to-digest diet after the symptoms are relieved.
Etiology
Causes
The common causes of upper respiratory tract obstruction are infectious inflammation, tongue retention, secretions, vomit, blood or foreign body obstruction, laryngeal edema, etc. Lower respiratory tract obstruction is often caused by tracheal and bronchial foreign bodies, occupying lesions or bronchospasm.
Questions you may be concerned about
Which part of the fracture is most likely to cause airway obstruction?
Bilateral fractures of the chinhole region are most likely to cause airway obstruction.
Bilateral fractures of the chin hole area, fractures of the center of the chin, and fractures of the condylar process may all cause respiratory obstruction. The bilateral chin foramen region is fragile due to the presence of the chin foramen and can be easily fractured by external forces.
When the chin foramen is fractured bilaterally, the mandible is divided into two parts due to the fracture, and the fractured segment of the anterior mandible can be displaced downward by the pull of the mandibuloglossus muscle, resulting in a posterior fall of the tongue, which in turn leads to obstruction of the respiratory tract by the tongue, causing respiratory tract obstruction.
The bilateral chin foramen area is fragile and there is a risk of respiratory obstruction after fracture.
Symptoms and Diagnosis
Typical symptoms
1. Clinical manifestations of respiratory obstruction include abnormal respiratory movements in the chest and abdomen, inspiratory stridor of different degrees, low or no respiratory sounds; in severe cases, there are the “three concave signs” of suprasternal and supraclavicular concavity subsidence, as well as invagination of the rib space, and the patient has difficulty in breathing and strong respiratory movements. 2. Tongue drop is manifested as the resistance of the airway when artificial respiration is carried out with a mask. When artificial respiration is performed with a mask, the resistance of the airway is large. Incomplete obstruction, snoring sound of varying intensity can occur with breathing; if it is complete obstruction, there is no snoring sound, only breathing action without gas exchange. When secretions accumulate in the pharynx or trachea, respiratory blister sounds can be heard during breathing.3. Laryngospasm is characterized by rapid inspiratory dyspnea, accompanied by high-pitched inspiratory rales in severe cases, and cyanosis occurs rapidly.
Diagnostic basis
1. Clinical manifestations show dyspnea, paradoxical respiratory movements, inspiratory stridor, etc. 2. X-ray examination shows displacement, compression, thinning of the trachea, and roughness and irregularity of the mucosa.
Treatment
Treatment policy
Keep the airway open, quickly relieve dyspnea, and give symptomatic treatment.
Medication
Antispasmodic drugs such as salbutamol, aminophylline, atropine, epinephrine, isoprenaline and corticosteroids should be used in cases of bronchospasm.
Other treatments
1. Upper respiratory tract obstruction (1) Tongue falling back: tilt the head back, hold up the jaw, or place a ventilation tube, suction secretions, vomit or blood, and remove the foreign body. (2) laryngospasm: stop all stimulation, use mask pressure to give oxygen or artificial respiration; in severe cases, cricothyroid puncture is feasible to give oxygen, or endotracheal intubation. (3) laryngeal edema: should be sloped position, oxygen, sedation, intravenous dexamethasone, and ready for tracheotomy.2. Lower respiratory tract obstruction in time to suction the secretion in the airway. After the occurrence of bronchospasm should keep the airway open, give pure oxygen inhalation. If necessary, endotracheal intubation is feasible to assist or control breathing.
Prognosis
The prognosis of this disease is poor, but if timely and effective treatment, the prognosis can be improved.
Nursing care
Daily care
1. Maintain a quiet and comfortable environment, keep the indoor air fresh and pay attention to ventilation. 2. Live a regular life and combine work and rest. 3. Comfort the patient and give psychological support to enhance his/her sense of security, so that he/she can keep his/her emotions stable.
Diet
Give light, vitamin-rich, easy-to-digest food, and avoid spicy and stimulating food.