When should I go to the hospital if I've ingested boiling water?

When to Seek Medical Care After Ingesting Boiling Water

You should immediately go to the hospital if you've ingested boiling water, as this is a medical emergency requiring prompt evaluation and treatment to prevent serious complications including esophageal burns, tissue damage, and potential airway compromise. 1

Immediate Actions Before Going to Hospital

• Apply cool running water to any external burns for 20 minutes, which significantly decreases the need for skin grafting and surgical intervention 2
• Do not attempt to induce vomiting as this may cause further damage to the esophagus 3
• Do not drink milk or water in an attempt to dilute the burn, as there is insufficient evidence that this provides benefit as a first aid measure 3
• Do not administer activated charcoal or any other substance by mouth 3

Indications for Immediate Medical Attention

• Any ingestion of boiling water requires emergency medical care due to risk of:
  • Thermal burns to the mouth, throat, and esophagus 1
  • Potential airway compromise from swelling 4
  • Risk of esophageal perforation 1
  • Intramural air formation (air within the wall of the esophagus) 1

What to Expect at the Hospital

• Initial assessment will likely include:

  • Evaluation of airway, breathing, and circulation 4
  • CT scan to assess the extent of injury and detect complications like intramural air or perforation 1
  • Possible endoscopy to directly visualize the extent of burns 1

• Treatment may include:

  • Airway management, which is critical as respiratory failure appears to be a proximate cause of death in severe cases 5
  • Parenteral nutrition (IV feeding) to allow the esophagus to heal 1
  • Placement of a nasogastric tube 1
  • Administration of proton pump inhibitors to reduce acid production 1

Special Considerations

• Children are particularly vulnerable to thermal injuries and require prompt medical attention due to their smaller airways which can swell quickly 6
• Elderly patients or those with pre-existing conditions may have more severe outcomes and should not delay seeking care 4
• If the person shows any signs of respiratory distress (difficulty breathing, stridor, wheezing), call emergency services immediately 3

Common Pitfalls to Avoid

• Delaying medical care in hopes that symptoms will improve on their own 3
• Attempting home remedies that may worsen the injury 3
• Underestimating the potential severity of internal thermal burns 1
• Failing to recognize that damage may be more extensive than initially apparent 5

Remember that unlike chemical burns, which may be diluted with water, thermal burns from boiling water have already caused tissue damage that requires professional medical evaluation and treatment 1, 5.