Respiratory distress in MWDs generally develops from the following anatomically based diseases and conditions:

• Upper airway obstructions (nasal cavity, oropharynx, larynx, and extra-thoracic trachea)
• Lower airway obstructions (intra-thoracic trachea and bronchi)
• Pulmonary parenchymal disease (bronchioles, alveoli, and interstitial space)
• Restrictive airway compromise (pleural space disease)

MWDs often display characteristic breathing patterns that help localize the problem to the primary anatomical area involved.

A clinical algorithm for differentiating the cause and location of an MWD’s respiratory distress is Figure 1.

Non-respiratory causes for respiratory distress in MWDs can include:

• Abdominal distension (gastric dilatation and volvulus, hemoperitoneum, organomegaly, masses, other)
• Respiratory ‘look-a-likes’ (e.g., cardiac disease, circulatory shock/hypotension, clinical anemia, pain, stress/fear, metabolic acidosis, neurological disease)

A thorough history, physical assessment, and basic point-of-care testing will rule out most of the non-respiratory causes listed above. The remainder of this chapter focuses on the emergent management of MWD Upper Airway Obstruction (UAO) disorders in a theater of operations.