Management of severe upper airway obstruction not due to a foreign body in children*

RSI: rapid sequence intubation; ICU: intensive care unit; LMA: laryngeal mask airway; OR: operating room.
* The following findings suggest upper airway obstruction:

• Inspiratory stridor, wheezing, or stertor
• Suprasternal or supraclavicular retractions
• Prolonged inspiratory phase
• Drooling
• Dysphagia

  Positions of comfort to help maintain airway patency in patients with severe obstruction:

• "Sniffing" position (neck is mildly flexed and head is mildly extended)
• Tripod position (leaning forward while bracing on the arms with neck hyperextended and chin thrust forward)

¶ Refer to UpToDate topics on evaluation of upper airway obstruction in children.
Δ For description of the technique and performance of cricothyrotomy and transtracheal ventilation, refer to UpToDate topics on needle and surgical cricothyrotomy.