Airway Obstructions

In order for oxygen from inhaled air to flow into the lungs, the upper airway must be unobstructed*. The upper airway includes the mouth, trachea ("windpipe") and its beginning branches. Upper airway obstructions may occur for several reasons:

1. The victim's tongue falls back into his throat while he is unconscious, either as a direct result of injury, or from cardiopulmonary arrest (commonly referred to as a "heart attack"). Contrary to urban legend, the tongue is never "swallowed." Rather, it falls backward toward the rear of the mouth, where it may obstruct the windpipe.
2. Something becomes lodged in the throat--most commonly, a piece of underchewed meat, or other food particle.
3. The contents of the stomach are regurgitated or vomited, and thus block the airway.
4. Blood clots may form as a result of head and facial injuries, and these clots block the airway.

*NOTE: Upper airway obstruction may be either partial or complete. See below.

Partial Airway Obstruction

In this scenario, the victim may still have partial, limited air exchange, but his ability to provide oxygen to his vital organs may nonetheless be compromised. The victim may be able to cough forcefully, but may wheeze between coughs. If this is the case, do not interfere, but encourage the victim to cough up the object on his own.

POOR AIR EXCHANGE may be indicated by:

• Weak coughing, accompanied by a high pitched wheezy noise between coughs.
• Cyanosis: Paleness of the skin, a bluish tint around the lips or fingernail beds, which indicates a lack of oxygen.

If these signs are present, treat the victim as if he had a complete airway obstruction.