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 happens when water is accidentally inhaled into the windpipe instead of being swallowed into the esophagus. This leads 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 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 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 breathe, monitor them closely. They are still 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 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 breathes 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 breathes 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 leads to complications like pneumonia.

Additionally, provide emotional support as the person feels 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 causes aspiration pneumonia and lead to hospitalization. Aspiration pneumonia causes serious complications, especially if you wait too long to visit the doctor. In this case, the infection progresses fast and spread to other areas of the body. It spreads to the bloodstream, which is very dangerous. In addition, pockets or abscesses forms in the lungs. Symptoms of choking on water includes:

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

 

Causes of Choking on Water

Choking on water happens when water enters the airway instead of the esophagus, which carries food and liquid to the stomach. This occurs 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.

 

According to research, individuals with neurological conditions like multiple sclerosis or Parkinson's disease, or those with anatomical abnormalities (such as cleft lip or palate), have a higher risk of choking on water.

What to do when choking on saliva?

Try to cough gently to clear your airway, as this helps 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, helps clear the airway. However, in cases of underlying medical conditions that affect swallowing or the cough reflex, there are 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 survives 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 is able to cough up the water and recover quickly, while in other cases, water inhalation leads to serious complications, such as pneumonia or acute respiratory distress syndrome (ARDS), which is 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.

What to do if a toddler is choking on water?

  1. Stay calm and assess the situation. Ensure that the child is indeed choking and unable to cough effectively, cry, or breathe.
  2. If the child is over one year old and choking:
    • Deliver up to 5 back blows between the shoulder blades with the heel of your hand.
    • If the back blows do not dislodge the object, perform up to 5 abdominal thrusts (only if the child is over one year old). To perform abdominal thrusts, stand or kneel behind the child, wrap your arms around their waist, place a fist above their navel, grasp your fist with the other hand, and thrust inward and upward.
  3. Call emergency services (911) if the choking persists.
  4. Continue cycles of 5 back blows and 5 abdominal thrusts until the object is dislodged or help arrives.

What to do when a baby chokes on water?

  1. Stay calm and assess the situation. Ensure that the baby is indeed choking and unable to cough effectively, cry, or breathe.
  2. For babies under one year old:
    • Sit down and lay the baby face down along your thighs, supporting their head with your hand.
    • Deliver up to 5 firm back blows between the shoulder blades with the heel of your hand.
    • If the back blows do not dislodge the object, turn the baby face up on your lap and perform up to 5 chest thrusts. Use two fingers placed in the center of the chest just below the nipple line and press downwards.
  3. Call emergency services (911) if the choking persists.
  4. Continue alternating 5 back blows and 5 chest thrusts until the object is dislodged or help arrives.

What happens when you choke on food?

Choking on food leads to obstruction of the airway, causing difficulty breathing. In severe cases, it leads to asphyxiation and death if not treated promptly. The Heimlich maneuver or chest thrusts is necessary to dislodge the obstructing food.

 

choking on water

How to Prevent Choking on Water?

Although anyone chokes 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 helps 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, further reducing the risk. If you have swallowing issues or medical conditions, consult a healthcare professional for guidance.

What Are Essential Advanced Airway Management Techniques for Choking on Water?

Essential advanced airway management techniques for choking on water include oropharyngeal and nasopharyngeal airways, endotracheal intubation, and supraglottic airway devices like laryngeal mask airways. These techniques are used when basic methods fail and should only be performed by trained medical personnel according to established protocols. Early assessment and intervention are crucial for optimal outcomes in choking emergencies.

Why is airway management a key component of first aid for choking on water?

Airway management is crucial in first aid for choking on water because it directly addresses the immediate threat to the individual's ability to breathe. Without effective airway management, the obstruction will lead to respiratory distress, hypoxia, and even death. By quickly and efficiently managing the airway, first responders significantly improve the chances of survival and minimize the risk of complications.

What Role Does CPR Play in Saving Lives During Water Choking Incidents?

CPRplays a critical role in saving lives during water choking incidents, especially if the individual becomes unconscious and stops breathing. Here's how CPR helps:

  1. Maintains Circulation: CPR helps maintain blood circulation to vital organs, including the brain, during a water choking incident. Effective chest compressions pump oxygenated blood throughout the body, sustaining essential functions until the airway obstruction is cleared or professional medical help arrives.
  2. Provides Oxygenation: By combining chest compressions with rescue breaths, CPR delivers oxygen to the lungs and bloodstream, addressing the oxygen deficiency resulting from airway obstruction. This helps prevent hypoxia (oxygen deprivation) and its associated complications, such as brain damage or cardiac arrest.

How Can Bystanders Effectively Use CPR in Water Choking Emergencies?

In water choking emergencies, bystanders effectively use CPR by ensuring their safety and assessing the scene first. If the individual is unresponsive, bystanders should immediately call for help and begin CPR, starting with chest compressions on a firm surface. After every 30 compressions, they should provide two rescue breaths. This cycle should continue until the person starts breathing normally, help arrives, or the bystander is too exhausted to continue. If available, an automated external defibrillator (AED) should be used according to its instructions. CPR performed promptly and correctly greatly enhances the chances of survival for the individual in distress.

CPR and First Aid Training

Many people underestimate the risk of choking on water, making CPR and first aid training even more vital. Most people experience choking at some point in their lives. There are situations where choking is usually short-lived and doesn’t pose any real danger. However, it’s important to remember that choking is dangerous and cause life-threatening complications. Therefore, it’s essential that we know what to do if we experience choking on water or witness it on someone else to help save a life. This is just one of the basic life-saving skills you learn when enrolling in a CPR/AED and First Aid certification classes.

With the advancement of technology and online learning, CPR classes are now easily accessible and available online for anyone to take. In fact, there are even CPR class for free available, which allows anyone to learn this vital skill without having to worry about the cost.

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Sources:

  • American Red Cross (https://www.redcross.org/take-a-class/heimlich-maneuver)
  • American College of Emergency Physicians (https://www.acep.org/how-we-serve/sections/disaster-preparedness-and-response/news/july-2019/the-dangers-of-drowning-what-you-need-to-know/)
  • American Heart Association (https://www.heart.org/en/health-topics/cardiac-arrest/resuscitation-science/cpr-steps-administering-cpr)
  • Cleveland Clinic and Michael J. Fox Foundation for Parkinson's Research