Treatment for Water Aspiration in the Hospital

Initial Management

The immediate treatment for water aspiration in a hospital setting should focus on airway management, oxygenation, and ventilation support, with prompt initiation of rescue breathing being the most important intervention for patients with respiratory compromise, as recommended by the American Heart Association 1
Immediately assess airway patency and breathing status; the first and most important treatment is the provision of ventilation, according to the American Heart Association 1
There is no need to attempt to clear aspirated water from the breathing passages by methods such as abdominal thrusts or the Heimlich maneuver, as these are unnecessary and potentially dangerous, as stated by the American Heart Association 1
Only a modest amount of water is typically aspirated, and it is rapidly absorbed into the central circulation, as noted by the American Heart Association 1
Perform suctioning of the airway to remove any visible water or vomitus, as recommended by the American Heart Association 1

For patients with respiratory distress or hypoxemia, initiate rescue breathing immediately, as recommended by the American Heart Association 1
If the patient is unresponsive and not breathing after delivery of 2 rescue breaths, check for pulse and begin CPR if pulseless, according to the American Heart Association 1
For drowning victims with respiratory arrest, healthcare providers should use the traditional A-B-C approach (rather than C-A-B) due to the hypoxic nature of the arrest, as stated by the American Heart Association 1

Patients with reduced level of consciousness are at high risk for aspiration and should not be fed orally until consciousness improves, as recommended by the American College of Chest Physicians 2
For patients with suspected dysphagia, consult a speech-language pathologist for swallowing evaluation, according to the American College of Chest Physicians 2