What happens during an attack
The larynx protects the airways from food and liquid, and this reflex is normally short-lived. With laryngospasm, the protective reaction becomes excessive: the vocal folds sharply close and do not diverge, the lumen is blocked. There is a feeling of complete inability to inhale, and attempts to inhale produce a characteristic whistling sound. Due to the lack of oxygen, excitement increases, then the muscles begin to relax and breathing is restored, often with a deep noisy breath. Severe, prolonged attacks are rare.
- Sharp closure of vocal folds
- Inability to inhale during saved attempts
- Noisy whistling sound when inhaling
- Redness, then bluishness of the face
- Self-terminating after seconds or a minute
- Deep noisy breath at the end of the attack
Causes in children and adults
In children of the first years of life, laryngospasm is classically associated with a decrease in calcium levels in the blood due to vitamin D deficiency, as well as with increased excitability of the nervous system. An attack is provoked by crying, fear, coughing, feeding. In adults, reflux-induced spasm is more common, especially at night, when the acidic contents of the stomach enter the larynx. A separate group is spasm during anesthesia and removal of the endotracheal tube, during inhalation of irritating vapors, ingestion of a foreign body, and during an allergic reaction.
- Vitamin D deficiency and decreased calcium in children
- Crying, fear, coughing as provocateurs
- Gastroesophageal reflux, especially at night
- Anesthesia and removal of the endotracheal tube
- Inhalation of smoke, vapors, irritants
- Entry of liquid or foreign body
- Allergic reaction and laryngeal edema
Symptoms and how to distinguish them from other conditions
The attack develops instantly, more often against the background of complete well-being or after a provoking moment. Unlike bronchial asthma, in which exhalation is difficult and wheezing is heard above the lungs, with laryngospasm it is precisely inhalation that is difficult, and the sound comes from the larynx. Unlike false croup, spasm is not accompanied by a barking cough, hoarseness and a gradual increase in symptoms during the evening. With anaphylaxis, a rash, swelling of the lips, tongue, and a drop in blood pressure appear simultaneously.
- Sudden onset
- Difficulty inhaling, not exhaling
- Noisy whistling breath
- Fright, excitement, cyanosis
- No barking cough, unlike croup
- No wheezing in the lungs, unlike asthma
- Rapid complete restoration of breathing
First aid and what not to do
During an attack, it is important to remain calm and reassure the child, since fear intensifies the spasm. The person is seated, a flow of fresh air is provided, tight clothing is unbuttoned, and the person is asked to breathe slowly through the nose. Washing with cool water and taking small sips of water after breathing has been restored can help. You should not try to unclench your teeth, pour liquid into your mouth when there is no breathing, shake or hit the back hard without signs of a foreign body. If the attack lasts and turns blue, immediately call an ambulance by number 103.
- Calm the victim and do not panic
- Sit down and provide access to fresh air
- Unbutton tight clothes
- Washing with cool water
- Do not pour liquid into your mouth if you are not breathing.
- Call 103 immediately in case of a prolonged attack
- If there are signs of anaphylaxis - emergency help
Examination and prevention of recurrences
After the attack, they must find out the cause. In young children, calcium and vitamin D levels are determined, signs of rickets are assessed, and prophylactic vitamin D supplementation is provided as prescribed by the pediatrician. For adults with nocturnal episodes, the larynx is examined and reflux is identified, and lifestyle changes and treatment are prescribed. It is important to avoid inhaling irritating substances, smoking, overheating and dry air. If attacks recur, the doctor excludes neurological causes and dysfunction of the larynx.
- Determination of calcium and vitamin D in children
- Prevention of rickets and sufficient exposure to air
- Examination of the larynx in adults
- Diagnosis and treatment of reflux
- Quitting smoking and inhaling irritants
- Indoor air humidification
- Observation by a specialist for recurrent attacks
