The recovery position is a standardized first aid technique designed for a person who is unconscious but still breathing normally. This specific posture involves placing the individual onto their side, which serves two primary, life-saving functions. First, it prevents the tongue—a muscle that relaxes completely when consciousness is lost—from falling back and obstructing the airway. Second, it uses gravity to allow any fluids, such as saliva, blood, or vomit, to drain freely from the mouth. This simple action significantly reduces the risk of aspiration, where stomach contents are inhaled into the lungs, which can lead to severe complications or suffocation.
When to Use the Recovery Position
The decision to use the recovery position hinges on two simultaneous conditions: the person is unresponsive and they are breathing adequately. Unresponsiveness means the individual cannot be roused by voice or touch, indicating a loss of protective reflexes that normally keep the airway clear. Normal breathing is the distinction that separates this maneuver from the need for cardiopulmonary resuscitation (CPR). Scenarios where this position is appropriate include unconsciousness resulting from intoxication, a non-life-threatening head injury, or post-seizure recovery.
This technique should not be used if the person is not breathing or is only gasping, as CPR is immediately necessary in those cases. Furthermore, moving an individual should be avoided if a severe spinal, neck, or head injury is suspected, such as after a major fall or car crash.
If movement is absolutely necessary in a suspected spinal injury case—for instance, if the person is vomiting—a modified “log roll” technique should be used to keep the head, neck, and spine aligned as a single unit. For pregnant individuals in the later stages, they should be placed on their left side when possible to prevent the uterus from compressing the inferior vena cava, which maintains proper blood flow.
Essential Steps Before Moving the Patient
Before attempting any physical movement, the safety of the scene must be quickly assessed to ensure no immediate dangers threaten the rescuer or the patient. Once the environment is secure, check for responsiveness by gently tapping the person and speaking loudly, asking “Are you okay?”. If there is no response, immediately check for normal breathing by looking for chest movement and listening for breath sounds for no more than ten seconds.
If breathing is confirmed, calling for emergency medical services (911 or local equivalent) should be done immediately, or delegated to a bystander. Before proceeding to the movement phase, remove any items from the person’s pockets, particularly on the side they will be rolled onto, such as keys or a large phone, to prevent injury during the movement. It is important to also check the mouth for any obvious obstructions, like loose dentures, and remove them if they are easily accessible.
Detailed Procedure for Placing Someone in the Recovery Position
Kneel beside the person and ensure their legs are straight before beginning the arm and leg positioning. Take the arm nearest to you and extend it straight out at a right angle to the body, with the palm facing upward. This extended arm will act as a stabilizer once the person is rolled onto their side. Next, take the arm farthest from you and bring it across the person’s chest, placing the back of their hand against the cheek closest to you.
Hold the hand gently against the cheek to support the head during the roll, preventing excessive neck movement. Now, use your free hand to grasp the leg farthest from you just above the knee, and bend the knee so the foot is flat on the ground. This bent leg creates the leverage necessary to roll the body. Carefully pull on the bent knee toward you, rolling the person onto their side in a controlled movement, with the hand supporting the head remaining in place.
Once the person is resting on their side, adjust the top leg so that both the hip and knee are bent at approximately right angles, which prevents them from rolling onto their stomach or back. The bent knee should be positioned forward to provide a stable base. The final, crucial step is to gently tilt the head back and angle the chin slightly upward, ensuring the airway is fully open and the mouth is directed downward to allow for continuous fluid drainage by gravity.
Post-Procedure Monitoring and Emergency Response
Once the person is stable in the recovery position, the priority shifts to continuous observation while awaiting professional help. Monitor their breathing closely, checking for the steady rise and fall of the chest and listening for clear breath sounds every minute. If at any point the person stops breathing or their breathing becomes irregular, they must be immediately rolled back onto their back to begin CPR.
To maintain body temperature, cover the person with a blanket or coat, as unconsciousness can impair the body’s ability to regulate heat. If help is delayed and the person remains in the position for more than 30 minutes, they should be carefully rolled onto their opposite side to relieve pressure on the limbs. This requires gently rolling them onto their back first, then repeating the entire procedure to position them on the other side. Remain with the individual, providing reassurance if they regain consciousness, until medical personnel arrive to take over care.
Detailed Procedure for Placing Someone in the Recovery Position
Kneel beside the person and ensure both of their legs are straight before beginning to manipulate the limbs. Take the arm closest to you and place it out at a right angle to the body, with the elbow bent and the palm facing upward. This outstretched arm creates a base for stability during the subsequent roll. Next, take the arm farthest from you and bring it across the chest, positioning the back of their hand against the cheek nearest to you.
Keep this hand pressed gently against the cheek, as it will be used to support and cushion the head during the movement. Use your other hand to grasp the leg farthest from you just above the knee, then bend it so the foot rests flat on the ground. This bent leg acts as a lever and provides the necessary mechanical advantage to move the body. Use the bent knee to pull the person gently but firmly toward you, rolling them onto their side in a controlled motion, ensuring the head is supported by the hand against the cheek.
Once the person is on their side, adjust the bent top leg so that the hip and knee are both flexed at right angles, which prevents the body from rolling over further. This positioning locks the person safely onto their side. For the final adjustment, gently tilt the head back to ensure a patent airway, and angle the chin so the mouth faces slightly downward, allowing any fluid to drain naturally with the assistance of gravity.
Post-Procedure Monitoring and Emergency Response
With the person safely in the recovery position, the focus must shift entirely to monitoring their condition while waiting for professional help. Continuously check their breathing by watching for the rhythmic rise and fall of the chest and listening for clear air movement. Reassess the breathing status at least every minute, as an unconscious person’s condition can change rapidly.
If at any time the person’s breathing stops or becomes ineffective, you must immediately and carefully roll them onto their back to begin chest compressions and rescue breaths. To prevent hypothermia, cover the person with a blanket or clothing, as unconsciousness compromises the body’s ability to regulate its core temperature. If medical assistance is delayed, the person should be gently rolled onto the opposite side after about 30 minutes to relieve pressure on the limbs and prevent potential nerve damage.