Choking on water can be fatal. This occurs when water is accidentally inhaled into the trachea instead of being swallowed into the esophagus. While the body’s natural reflexes often clear the airway, a significant amount of water or a prolonged obstruction can lead to serious consequences. Understanding the process and appropriate responses can help mitigate risks.
How Water Causes Choking
The human body possesses a protective mechanism to prevent water from entering the airways. The epiglottis, a small, leaf-shaped flap of cartilage at the base of the tongue, covers the opening of the larynx during swallowing. This diverts liquids into the esophagus. If this coordination is disrupted, water can mistakenly enter the trachea, a phenomenon known as aspiration.
When water enters the trachea, it triggers laryngospasm, an involuntary contraction of the vocal cords. This reflex causes the vocal cords to clamp shut, temporarily blocking the airway. While this is a protective response, a sustained laryngospasm or a large volume of aspirated water can lead to a sudden inability to breathe. This obstruction can result in oxygen deprivation, which, if prolonged, can cause complications like aspiration pneumonia or be life-threatening.
Signs of Serious Aspiration
Serious water aspiration presents distinct signs beyond a minor cough. A persistent, forceful cough is often the body’s initial attempt to clear the airway. However, if the person struggles to breathe, produces wheezing or gasping sounds, or cannot speak, it may signal a more significant obstruction.
Further indicators of severe aspiration include a look of panic or distress, bluish discoloration around the lips or face (cyanosis), which suggests a lack of oxygen, and gagging. In the most severe instances, if the airway becomes completely blocked, the individual may lose consciousness.
Immediate Response to Choking
Quick and effective response is crucial when someone is choking on water. If the person is conscious and coughing forcefully, encourage them to continue coughing, as this is the body’s natural way to clear the airway. Avoid patting their back if they are coughing effectively, as this might dislodge the water deeper into the airway. If coughing does not clear the airway and the person is struggling to breathe, administer five firm back blows between their shoulder blades with the heel of your hand, while leaning them forward.
If back blows are unsuccessful, perform abdominal thrusts (Heimlich maneuver). Stand behind the person, wrap your arms around their waist, and make a fist with one hand, placing it just above their navel. Grasp your fist with your other hand and deliver quick, upward thrusts into the abdomen. If the person becomes unconscious, immediately call emergency services and begin cardiopulmonary resuscitation (CPR), starting with chest compressions.
Factors Increasing Risk
Several factors increase the risk of serious water aspiration. Age plays a role, with infants and toddlers being at higher risk due to smaller airways and developing swallowing reflexes. Older adults are also more vulnerable, often experiencing age-related declines in swallowing function, known as dysphagia. Dysphagia can result from neurological disorders like stroke, Parkinson’s disease, or dementia.
Medical conditions such as gastroesophageal reflux disease (GERD) can also increase aspiration risk. Conditions that reduce the cough or gag reflex, including some medications or sedation, also lessen protective responses. Situational factors like drinking while talking, laughing, or exercising vigorously can disrupt the swallowing process, making accidental water inhalation more likely.