Management of upper airway obstruction due to a foreign body in children*

FB: foreign body; CPR: cardiopulmonary resuscitation; RSI: rapid sequence intubation; ETT: endotracheal tube; OR: operating room.
* The following findings suggest upper airway obstruction:

• Inspiratory stridor, wheezing, or stertor
• Suprasternal or supraclavicular retractions
• Prolonged inspiratory phase
• Oral mucosa or tongue swelling
• 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 algorithms and topics on pediatric basic life support for health care providers and FB obstruction.
Δ Refer to UpToDate topics on evaluation of upper airway obstruction in children.
◊ Surgical cricothyrotomy may be appropriate in selected patients younger than 12 years of age, as determined by cricothyroid membrane size. Refer to UpToDate topics on needle and surgical cricothyroidotomy.