Introduction: The Unseen Dangers
When we imagine someone drowning, most of us picture a scene from a movie: dramatic splashing, arms flailing, and loud cries for help. We think of choking as a sudden, violent event that is immediately obvious. While these scenarios can happen, the reality is often tragically different. The most dangerous situations are frequently silent, and the risks don’t always end once a person is pulled from the water or seems to be breathing again.
The truth is that suffocation—whether from water or a foreign object—is surrounded by critical misunderstandings. Our instincts on how to help can sometimes do more harm than good, and hidden dangers can emerge hours after an incident appears to be resolved. Common sense isn’t always the correct response in these life-or-death moments.
This article will reveal several life-saving facts that challenge these common assumptions. Understanding these nuances is not just interesting; it’s knowledge that can empower you to act correctly and effectively in a real emergency, potentially saving a life.
- Drowning Can Happen Hours After Leaving the Water
One of the most dangerous misconceptions is that once a person is out of the water and breathing, the threat is over. In reality, two life-threatening conditions, often called “dry drowning” and “secondary drowning,” can occur hours or even days after a water incident.
- Dry Drowning: This occurs not because water fills the lungs, but because inhaling water causes the vocal cords to spasm and close the airway. Even if the person is out of the water, this spasm can persist, blocking their ability to breathe.
- Secondary Drowning: This is a delayed reaction that happens after even a small amount of water gets into the lungs. The water irritates the lung lining, causing inflammation and a slow buildup of fluid (pulmonary edema). This danger is amplified by the type of water; for instance, inhaled salt water can draw even more fluid into the lungs, leading to a more severe pulmonary edema, while fresh water is absorbed into the bloodstream more quickly. Over the next several hours, this fluid can make it impossible for the body to get enough oxygen.
Because these conditions are delayed, it’s critical to watch for symptoms after any water-related struggle, no matter how minor it seemed. Key symptoms include a persistent cough, difficulty breathing or wheezing, chest pain, extreme fatigue, and confusion or changes in mental state.
“Even if a person seems to have recovered completely after a water incident, the risk is not over. The delayed effects of even a small amount of water in the lungs can lead to serious respiratory problems hours or days later, which is why a medical evaluation is always necessary.”
- Hitting a Choking Person on the Back Can Make It Worse
When you see someone choking, the instinctive reaction is often to give them a hard slap on the back. However, this can be the wrong—and most dangerous—thing to do, depending on the situation. It’s crucial to first identify whether the airway obstruction is partial or complete.
- Partial Obstruction: If the person can still cough, speak, or breathe, the airway is only partially blocked. In this case, your single most important action is to encourage them to keep coughing. Coughing is the body’s most effective natural mechanism for clearing an object. Do not hit them on the back. A back blow at this stage can dislodge the object just enough to turn a partial blockage into a complete, life-threatening one by forcing it deeper into the airway.
- Complete Obstruction: If the person cannot cough, speak, or breathe and may be turning blue, the airway is completely blocked. This is a true emergency that requires immediate intervention, such as the Heimlich Maneuver.
- The Heimlich Maneuver Must Be Adapted for Different People
The standard Heimlich Maneuver is a powerful tool for complete choking emergencies. However, it is not a one-size-fits-all technique. Applying it incorrectly or to the wrong person can be ineffective or even cause serious injury. The method must be adapted for babies, pregnant individuals, and people who are significantly overweight.
- Adults and Children (over 1 year): The standard procedure is a cycle of two actions. Stand behind the person and deliver five firm blows to their back between the shoulder blades with the heel of your hand. After this, perform five abdominal thrusts. To do this, make a fist and place it just above their navel. Use your other hand to perform quick, upward thrusts. This cycle of 5 back blows and 5 abdominal thrusts is repeated until the object comes out or the person loses consciousness.
- Babies (under 1 year): Abdominal thrusts are dangerous for infants. Instead, the correct procedure is a cycle of 5 back blows and 5 chest thrusts. Lay the baby face-down along your forearm, supporting their head. Deliver five firm blows to the back between the shoulder blades. Then, turn the baby over and, using two fingers, deliver five quick thrusts to the center of their chest.
- Pregnant or Obese Individuals: Abdominal thrusts are either unsafe for the fetus or ineffective due to body size. For these individuals, the hand position is moved higher up. The thrusts should be applied to the center of the breastbone (chest thrusts) instead of the abdomen.
- First Aid for Water Drowning Has a Unique First Step
In standard CPR training, the protocol for a person who isn’t breathing and has no pulse is to immediately start the cycle of 30 chest compressions followed by 2 rescue breaths (30:2). However, in the specific case of a drowning victim rescued from the water, first aid guidelines recommend a critical preliminary step.
Before beginning the 30:2 cycle, the first action should be to deliver 5 initial rescue breaths.
The reasoning for this is vital. Unlike a typical heart attack on land (a primary cardiac event), cardiac arrest in a drowning victim is almost always a secondary event caused by a severe lack of oxygen (hypoxia). Their heart has stopped because their brain and body have been deprived of air. Providing five initial breaths directly addresses this urgent need for oxygen, re-saturating the bloodstream before chest compressions begin circulating that oxygen to the vital organs.
Conclusion: Knowledge is a Lifesaver
In a crisis, our instincts guide us, but as these examples show, common sense is not always correct in an emergency. The line between helping and harming can be razor-thin, and it is defined by accurate knowledge. Understanding the silent signs of secondary drowning, resisting the urge to slap a coughing person on the back, and knowing how to adapt life-saving techniques are the kinds of details that truly make a difference.
Now that you know what you don’t know, are you prepared to handle a real emergency?
