Suffocation : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 28/09/2022

Suffocation is a pronounced lack of air, an extreme manifestation of shortness of breath, accompanied by a feeling of fear of death. It is caused by diseases of the respiratory tract, cardiovascular pathology, chest injuries and other conditions. Asphyxiation is diagnosed on the basis of clinical data, its causes are established using radiation diagnostics, functional examination, and endoscopy. When providing emergency care, it is necessary to ensure adequate ventilation of the respiratory tract. Further treatment depends on the cause of this condition.

Causes of suffocation

Bronchial asthma

The most common causes of attacks of pronounced shortness of breath are respiratory diseases. Most often, suffocation develops with bronchial asthma. Attacks of difficulty breathing due to primary bronchial hyperreactivity are the main clinical manifestation of this disease, develop upon contact with allergens and physical stress, are provoked by respiratory infections and psycho-emotional stress.

The feeling of lack of air occurs at any time, often at night and in the morning. The number and severity of seizures can vary throughout the day. Shortness of breath is accompanied by a feeling of tightness in the chest, wheezing, unproductive cough. Light suffocation resolves on its own, medications are used to stop a severe episode of shortness of breath. With inadequate treatment, the attack is sometimes delayed - an asthmatic status is formed.


Suffocation caused by narrowing of the airway is common in a number of different conditions. The clinical picture of the bronchospastic state resembles an attack of bronchial asthma. However, bronchospasm in other nosologies is secondary, develops against the background of acute pathological processes or exacerbation of chronic diseases. The main causes of secondary bronchoconstriction are:

  • Respiratory infections. Choking in acute bronchitis and bronchiolitis often occurs in preschool children. In addition to difficulty breathing, there is a dry or productive cough, fever to subfebrile or febrile values, signs of general intoxication. The phenomena of bronchial obstruction against the background of bronchial tuberculosis, pulmonary syphilis appear during a stable remission of the underlying disease.
  • Chronic inflammatory processes. For COPD, chronic bronchitis, bronchiectasis is characterized by a slowly progressive course, persistent cough with sputum, hemoptysis. Episodes of bronchospasm are noted during the period of exacerbation of the pathological process.
  • Allergic reactions . The cause of severe bronchial obstruction is often various allergic reactions. Choking develops as a result of anaphylaxis when the allergen enters the body again. Often occurs with insect allergy, serum sickness, drug intolerance.
  • Autoimmune diseases. Severe systemic lupus erythematosus, scleroderma, periarteritis nodosa may be accompanied by asthma attacks. With such pathologies, skin rashes, polyarthralgia, fever are observed, the functions of the urinary, cardiovascular and other systems are disturbed.

Less commonly, episodes of bronchospasm are found in cardiovascular insufficiency, thrombosis and pulmonary embolism, endocrine diseases (hypoparathyroidism, hypothalamic syndrome, Addison's disease). Inhalation of dust, irritants, poisoning with phosphorus compounds, taking beta-blockers can also provoke suffocation.


Injuries and diseases of the pleura

Violation of the integrity of the pleura, accumulation of air (pneumothorax) or fluid (hemothorax) in its cavity cause collapse of the lung, displacement of the mediastinum to the healthy side. The pulmonary excursion is limited, the main vessels are compressed. The severity of suffocation depends on the amount of pathological contents of the pleural cavity. Shortness of breath is accompanied by pain in the chest, dry cough.

Foreign body inhalation

Foreign body aspiration is a fairly common cause of sudden difficulty in breathing in young children. Children tend to take various small objects into their mouths, which, when frightened, crying or laughing, enter the respiratory tract and can cause suffocation. Adults usually aspirate foreign objects in violation of chewing and swallowing functions or in a state of alcoholic intoxication.

Clinical manifestations of aspiration depend on the size, shape and properties of the object that has entered the airways. Large foreign bodies of the larynx and trachea can stop the flow of air into the respiratory tract and lead to the death of the victim within a few minutes. A foreign object often partially blocks the lumen of the upper respiratory tract, less often foreign bodies of the bronchi are detected.

The victim develops a painful reflex cough, inspiratory dyspnea. Auxiliary muscles are included in the act of breathing. There is a retraction of the intercostal space, the epigastric region during inspiration. Breathing becomes stridorous, the skin becomes bluish.

Pathology of the larynx

Other common causes of choking in childhood are conditions leading to laryngospasm and acute laryngeal stenosis. Laryngospasm is a sudden involuntary contraction of the muscles of the larynx and is usually detected in children under 3 years of age against the background of spasmophilia. It can be caused by inflammatory diseases of the lungs, instillation of certain drugs into the nose. In adults, laryngospasm is rare, observed with eclampsia, tetany, inhalation of irritants.

Suffocation comes on suddenly. It provokes stress, crying, fear. Breathing becomes noisy. The patient turns pale, gasps for air with an open mouth. The head is thrown back, the neck muscles are tense. There comes a short-term cessation of breathing, which ends with a long whistling breath. Seizures may be repeated. Prolonged respiratory arrest is accompanied by convulsions and can be fatal.

Acute laryngostenosis is observed in infectious and inflammatory processes, tumors and injuries of the larynx. Other causes of narrowing of the lumen of the organ include Quincke's edema in the larynx, volumetric formations of neighboring organs, some diagnostic and therapeutic manipulations. Asphyxiation develops in stages, goes through the stages of sub- and decompensation, in the absence of adequate assistance, ends with the death of the patient from asphyxia.

Inhalation injury

Asphyxiation in case of inhalation injury appears due to thermal burns of the respiratory tract and poisoning by combustion products. Such injuries in victims during a fire aggravate the course of burn disease and cause high mortality. The presence of burns in the face and neck indicates the possibility of inhalation damage to the respiratory tract. The pronounced difficulty in breathing is preceded by a change in the timbre of the voice, coughing up soot.

The main toxic products of combustion - carbon monoxide, cyanides, phosgene and chlorine - are manifested by suffocation, tightness and pain in the chest. There are signs of intoxication. The victim is disturbed by excruciating headaches, nausea, vomiting. In severe cases, hallucinations and delusions join, up to a complete loss of consciousness.


Diagnostic search is carried out by pulmonologists together with otorhinolaryngologists. Fire victims are being examined by surgeons. An asthma attack is diagnosed by characteristic clinical manifestations. With the help of a survey, the frequency of occurrence of episodes of shortness of breath and provoking factors are established. To determine the cause of the pathological condition, the following are used:

  • Endoscopic studies. Endoscopic procedures for suffocation in some cases are therapeutic and diagnostic. During laryngoscopy, the larynx is examined, and the trachea is intubated. With the help of bronchoscopy, foreign bodies are removed, and the tracheobronchial tree is sanitized.
  • visualization techniques. Plain radiographs, CT, MRI of the chest organs reveal inflammatory and neoplastic processes of the bronchi, lung parenchyma, and pleural cavities. Ultrasound of the thyroid gland reveals formations that compress the trachea or larynx.
  • Functional research. Pulse oximetry measures the level of oxygen saturation in the blood. ECG helps to confirm acute cardiovascular pathology. Spirography is performed for the differential diagnosis of bronchial asthma with other respiratory diseases.
  • Laboratory tests. To exclude specific damage to the lungs, parasitic invasions, bacteriological studies of sputum are performed, serological diagnostics are carried out. In the blood serum, markers of oncological and autoimmune processes can be detected. Pathological agents that provoke anaphylaxis are established by the methods of allergy diagnostics.


Help before diagnosis

Asphyxiation is a medical emergency, the main goal of which is to restore airway patency. As pre-medical measures, it is necessary to ensure the flow of fresh air - open the window, free the patient from tight clothing, take the victim out of the fire to the street. A foreign object in the respiratory tract should be tried to be removed using the Heimlich maneuver.

Conservative therapy

The choice of tactics of etiopathogenetic treatment depends on the immediate cause of suffocation. For burn patients, therapeutic bronchosanations are relevant, and cardiotropic drugs are prescribed for patients with cardiovascular pathology. In the treatment of diseases of the respiratory system accompanied by suffocation, the following groups of drugs are most often used:

  • Bronchodilators. Include beta-agonists, anticholinergics, methylxanthines. Medicines can quickly stop broncho-, laryngospasm. Preparations of this group are divided into high-speed and prolonged. Beta-adrenergic agonists and anticholinergics can be prescribed as a monodrug, in combination with each other and with inhaled corticosteroids.
  • Corticosteroids. They are used in the provision of emergency care to patients with bronchial obstruction, laryngospasm, anaphylaxis. Topical inhaled forms of corticosteroids are used as basic therapy for bronchial asthma, COPD and other diseases of the respiratory system.

If necessary, oxygen therapy, respiratory support is provided. Epinephrine is given for anaphylaxis. Patients with allergic diseases are prescribed antihistamine and antileukotriene drugs, allergen-specific immunotherapy is performed. Infectious and inflammatory lesions of the bronchopulmonary system are treated with antibiotics.



With the ineffectiveness of conservative measures, the impossibility of tracheal intubation, patients with laryngeal obstruction are subjected to a tracheostomy. To evacuate exudate or air from the pleural cavity, thoracocentesis is performed, if necessary, drainage is installed. Operatively, tumors of the organs of the chest cavity are radically removed.

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