Laryngospasm
Sudden spasm of vocal cords causing airway obstruction
Definition
Laryngospasm is a sudden, involuntary spasm of the laryngeal muscles that causes closure of the glottis and airway obstruction. Brief laryngospasm may resolve spontaneously; prolonged spasm is a medical emergency.
Causes
- Post-thyroidectomy hypocalcemia (decreased parathyroid function)
- Anesthesia-related (irritation of vocal cords)
- GERD with aspiration
- Allergic/anaphylactic reaction
- Foreign body
- Smoke or chemical irritation
Signs and Symptoms
Inspiratory stridor, respiratory distress, hoarseness, cyanosis, silent chest (severe). Post-thyroidectomy: associated with hypocalcemia signs, such as chvostek, Trousseau, tetany.
Nursing Interventions
Position upright, administer humidified oxygen, call rapid response/code. Post-thyroidectomy: have tracheostomy tray and calcium gluconate at bedside; IV calcium gluconate for hypocalcemic laryngospasm. Prepare for reintubation if needed.
NCLEX Relevance
Post-thyroidectomy: monitor for stridor and hypocalcemia. Calcium gluconate at bedside.