First Aid for Water Choking: Immediate Steps and Precautions

Choking is the fourth leading cause of unintentional injury death, including choking on water. Yes, it is possible to choke on water. This can happen when water is accidentally inhaled into the windpipe instead of being swallowed into the esophagus. This can lead to coughing and difficulty breathing. Here are first aid steps on how to relieve choking on water:

  1. Assess the Situation: Assess the severity of the situation. Is the person coughing forcefully or able to breathe, even if it's difficult?
  2. Encourage Coughing: If the person is coughing, encourage them to keep coughing. Coughing is the body's natural way of clearing the airway. Do not forcefully pat the person on the back. This can sometimes push the water further down the airway.
  3. Perform the Heimlich Maneuver: If coughing doesn't work, perform Heimlich maneuver until the water is expelled, and the person can breathe or cough effectively.
  4. Perform CPR: If the person loses consciousness, begin CPR immediately if the person is not breathing.
  5. Monitor and Provide Support  After the water is expelled, and the person can breathe, monitor them closely. They may still be at risk of complications like pneumonia or shock.

choking on water

Assess the Situation

Start by quickly assessing the severity of the situation. Look for signs of choking, such as the person clutching their throat or displaying difficulty speaking or breathing. Observe if the person is coughing forcefully or if they're struggling to breathe, even if it's challenging. Additionally, check their overall condition, including their skin color (if it's turning bluish) and their responsiveness.


Encourage Coughing

If the person is actively coughing, provide immediate reassurance and urge them to continue coughing. Explain that coughing is the body's natural mechanism for clearing the airway of foreign objects, including water. Stress the importance of forceful coughing as it provides the best chance of expelling the water from their airway.

It's essential to avoid forcefully patting the person on the back. While this might be the instinctual response, it can sometimes push the water further down the airway and worsen the situation. Stay with the person and offer verbal support to help them remain calm and focused on coughing.


Perform the Heimlich Maneuver

If the person cannot cough effectively and is not breathing, it's time to perform the Heimlich maneuver (abdominal thrusts):

  1. Stand behind the person and wrap your arms around their waist.
  2. Place a fist slightly above the navel but below the ribcage.
  3. Grab your fist with your other hand.
  4. Give quick, upward thrusts into the abdomen. The goal is to force the water and any obstructing material out of the airway.
  5. Repeat these thrusts until the water is expelled and the person can breathe or cough effectively.


Perform CPR

If the person loses consciousness and is not breathing, it's crucial to initiate CPR or Cardiopulmonary Resuscitation immediately.

  1. Begin CPR with chest compressions. Place the heel of one hand on the center of the person's chest, just below the nipple line. Place your other hand on top and interlock your fingers.
  2. Use your body weight to perform chest compressions, pressing the chest down at least 2 inches deep and at a rate of 100-120 compressions per minute.
  3. After every 30 chest compressions, give two rescue breaths. Tilt the person's head back slightly to open the airway, pinch their nose shut, and provide a breath lasting about one second.
  4. Continue this cycle of chest compressions and rescue breaths until help arrives, the person starts breathing alone, or you are too exhausted to continue.


Monitor and Provide Support

Once the water is expelled, and the person can breathe or cough effectively, stay by their side and offer reassurance. Continuously monitor their condition, watching for any signs of respiratory distress, such as labored breathing or changes in skin color. Be prepared to seek immediate medical attention, even if the person seems fully recovered, as water aspiration can lead to complications like pneumonia.

Additionally, provide emotional support as the person may feel shaken or anxious following the choking episode. Encourage them to remain calm and reassure them that they are safe and receiving appropriate care.

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What Happens When You Choke on Water?

If you drink a glass of water or from a water bottle, and it gets into your lungs, it can cause aspiration pneumonia and lead to hospitalization. Aspiration pneumonia can cause serious complications, especially if you wait too long to visit the doctor. In this case, the infection may progress fast and spread to other areas of the body. It may also spread to the bloodstream, which is very dangerous. In addition, pockets or abscesses may form in the lungs. Symptoms of choking on water may include:

  • Coughing or wheezing.
  • Gurgling or struggling to breathe.
  • Cyanosis (bluish skin or lips).
  • Distress and panic.


Causes of Choking on Water

Choking on water can happen when water enters the airway instead of the esophagus, which carries food and liquid to the stomach. This can occur due to:

  • Inhaling or aspirating water while swimming or bathing.
  • Accidentally inhaling water while drinking.
  • Falling into water unexpectedly, such as a pool, lake, or bathtub.
  • Participating in water activities like diving or water sports.


Risk factors of choking on water

Certain factors increase the risk of choking on water, including:

  • Alcohol or drug use impairing coordination and judgment.
  • Weak swimming skills.
  • Epilepsy or seizures in the water.
  • Medical conditions affecting swallowing or cough reflex.


What to do when choking on saliva?

Try to cough gently to clear your airway, as this may help dislodge the excess saliva. If possible, spit out the excess saliva into a tissue or a nearby container to remove it from your mouth and prevent further choking. If you continue to experience difficulty or the situation worsens, consider seeking medical attention or contacting a healthcare professional for guidance. Choking on saliva is usually a temporary and manageable issue, but it's essential to respond calmly and effectively to ensure your safety.


Can you die from choking on water or saliva?

Choking on water or saliva is usually not life-threatening for most people. The body's natural reflexes, like coughing, can help clear the airway. However, in cases of underlying medical conditions that affect swallowing or the cough reflex, there may be more significant risks. While these situations are typically manageable, it's essential to consult a healthcare professional if you have concerns about frequent choking incidents or swallowing difficulties to address any underlying issues and receive appropriate guidance.


How long can a person survive after choking on water?

The amount of time a person can survive after choking on water depends on various factors, including the amount of water ingested, the person's age and overall health, and how quickly the person receives medical treatment. In some cases, a person may be able to cough up the water and recover quickly, while in other cases, water inhalation can lead to serious complications, such as pneumonia or acute respiratory distress syndrome (ARDS), which can be fatal.


What should you do if someone is choking on water and becomes unconscious?

If someone is choking on water and becomes unconscious, immediately call for emergency medical services (EMS) and start CPR. The American Heart Association recommends starting CPR with chest compressions and rescue breaths until EMS arrives. If water is visible in the person's airway, it should be cleared with a finger sweep. However, if no water is visible, rescue breaths should be given without delay.


choking on water

How to Prevent Choking on Water?

Although anyone can choke on water and saliva because of the proximity of the windpipe to the esophagus, some medical conditions make choking more likely. Some ways to prevent choking in vulnerable people include regular airway suctioning, breathing exercises, and swallowing or speech therapy. 

To prevent choking while drinking water, take smaller sips, sit upright, and sip slowly. Using a straw can help control the flow, and it's essential to stay calm and relaxed while drinking. Taking breaks, avoiding alcohol or sedatives before drinking, and practicing safe habits, especially for children, can further reduce the risk. If you have swallowing issues or medical conditions, consult a healthcare professional for guidance.