How to Know When Airway Discomfort Is a Serious Problem

A number of things, including allergies, a minor cold, and the flu can all cause airway discomfort. And complications from these usually minor conditions can be dangerous, especially in vulnerable people such as elders and children. Also, serious conditions such as aspiration, partial obstructions, pneumonia, and other disorders may also trigger airway discomfort. As a first responder, it’s important to know when airway discomfort is a sign of a serious problem, or just a passing symptom. 


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Normal vs. Worrisome Airway Discomfort 

You can’t diagnose a patient based on airway discomfort alone, but certain types of discomfort are more worrisome than others. Use the following symptom checklist to help guide your exam.


It’s normal:

  • For breathing to feel unpleasant or annoying when someone has a cold. 
  • To work a little harder to breathe as a common side effect of respiratory illnesses.
  • To feel a tickle or other unpleasant sensation in the throat with a cold. This often gets better with coughing or water. 
  • To cough. 

It’s not normal:

  • To have truly painful breathing with a cold.
  • To gasp, gag, or feel that it’s impossible to take a breath with a respiratory illness.
  • To feel like there is a large object in the throat–this may signal an obstruction.
  • To feel like there is water in the chest.
  • To have a truly painful cough accompanied by a barking sound. This suggests that a person may have croup. 

Signs of Respiratory Distress 

The initial respiratory exam should also include checking for symptoms of respiratory distress. They include: 


  • Retractions or nostril flaring in newborns and young infants 
  • Cyanosis, especially of the lips, fingernails, tongue, or toes 
  • Loud breathing, including barking or wheezing sounds 
  • A very high respiratory rate 
  • Low blood pressure 
  • A patient who says they cannot get enough air 
  • Signs of hypoxia, such as a low-pulse oximeter reading 

In newborns, even mild respiratory distress can be life-threatening, and may indicate a congenital defect or a serious illness. So providers must take even subtle signs of airway problems seriously by providing stabilizing care and promptly transporting to the patient to a hospital that can manage the unique needs of pediatric patients.


When to Intervene 

The right treatment depends on the reason for the patient’s airway discomfort. People who only report airway discomfort but show no signs of respiratory distress should still be transported. If a person is in respiratory distress, however, protecting the airway is key. Some patients will need to be suctioned, so be prepared with a variety of catheters and a portable suction machine. Some patients will also need supplemental oxygen. First responders should not hesitate to intervene, but should also avoid invasive measures unless and until they are certain that they are necessary. 


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The Right Equipment Matters

Patients who require airway protection and management are already vulnerable. They may have infections or chronic illnesses that weaken their immune system, and so it’s critically important to tend to them as quickly as possible, and to use reliable airway suction that works quickly. Portable emergency suction allows you to quickly treat a patient with consistent suction no matter where they are or how difficult it is to move them. A portable device should be part of every first responder’s emergency kit. 


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Editor's Note: This blog was originally published in January 2020. It has been re-published with additional up-to-date content.