Because of this importance, loss of patency becomes the most urgent emergency that can be imagined in medicine. Rapid accurate recognition and treatment of airway emergencies are essential to the provision of emergency and critical care medicine. The natural human airway consists of the nasopharynx and oropharynx, the larynx, and the trachea. Most airway emergencies result from obstruction to airflow. Obstruction can result from internal obstruction either by edema, spasm, or a foreign body, or from external compression or distortion.
Airway obstructions can be congenital or acquired.
Examples of congenital airway obstructions are tracheal atresia, laryngeal web, choanal atresia, and vascular ring with tracheal compression. These congenital obstructions, if severe enough, can result in death in the delivery room if immediate surgical intervention is not provided. Foreign Body Aspiration Foreign body aspiration normally occurs during eating, particularly when the patient has an impaired gag reflex such as might be caused by consuming alcohol or by anatomical neurological deficits as might be seen following a stroke. With a complete obstruction, there is no sound of air movement audible at the mouth and the patient is unable to speak. Sternal, suprasternal, costal, and infracostal retractions are also common in upper airway obstruction as is a piston-like motion of the trachea as seen in the neck with inspiratory efforts.