Summary
Definition
History and exam
Key diagnostic factors
- choking crisis
- unilateral decreased breath sounds
- unilateral wheezing
Other diagnostic factors
- intractable cough
- fever
- dyspnea
- bilateral wheezing
Risk factors
- decreased level of consciousness (Glasgow coma score <9)
- age <4 years
- age >70 years
- bulbar dysfunction
- male sex
- cerebrovascular disease
- dementia
Diagnostic tests
1st tests to order
- chest x-ray
Tests to consider
- CT chest
- bronchoscopy
Emerging tests
- ultrasound lung
Treatment algorithm
conscious
unconscious
Contributors
Authors
Arjun B. Chatterjee, MD, MS, FACP, FCCP, FAASM
Professor of Medicine
Section on Pulmonary, Critical Care, Allergy, and Immunologic Disease
Wake Forest University School of Medicine
Winston-Salem
NC
Disclosures
ABC declares that he has no competing interests.
Acknowledgements
Dr Arjun B. Chatterjee would like to gratefully acknowledge Dr Septimiu Murgu and Dr Henri Colt, the previous contributors to this topic. SM and HC declare that they have no competing interests.
Peer reviewers
Amber Young, BSc, MB ChB, FRCA
Consultant Paediatric Anaesthetist
Department of Anaesthesia
Frenchay Hospital
Bristol
UK
Disclosures
AY declares that she has no competing interests.
Momen M. Wahidi, MD, MBA
Professor of Medicine
Pulmonary and Critical Care
Feinberg School of Medicine
Northwestern University
Chicago
IL
Disclosures
MMW declares that he has no competing interests.
Pyng Lee, MD
Senior Consultant
Department of Respiratory and Critical Care Medicine
Singapore General Hospital
Singapore
Disclosures
PL declares that he has no competing interests.
Prashant Mahajan, MD, MPH, MBA
Professor of Emergency Medicine and Pediatrics
Vice-Chair
Department of Emergency Medicine
Chief
Pediatric Emergency Medicine
C S Mott Children's Hospital and University of Michigan Medical School
Ann Arbor
MI
Disclosures
PM declares that he has no competing interests.
Karima Lelak, MD
Clinical Assistant Professor
Department of Emergency Medicine and the Department of Pediatrics
C.S. Mott Children's Hospital
University of Michigan
Ann Arbor
MI
Disclosures
KL declares that she has no competing interests.
Differentials
- Asthma exacerbation
- Cystic fibrosis with exacerbation
- Acute COPD exacerbation
More DifferentialsGuidelines
- 2023 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations
- European Resuscitation Council guidelines 2021: Executive summary
More GuidelinesPatient information
Pneumonia
Bronchoscopy
More Patient informationVideos
Stridor
Expiratory wheeze
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