The recovery position is a specific body posture used in first aid for an unconscious person who is still breathing normally. Its main purpose is to maintain an open airway and help fluids drain from the mouth, reducing the risk of choking or aspiration while awaiting professional medical assistance.
Why the Recovery Position is Vital
Placing an unconscious person in the recovery position addresses several physiological concerns. When an individual loses consciousness, throat muscles can relax, potentially causing the tongue to fall back and obstruct the airway. The side-lying posture uses gravity to keep the tongue from blocking the air passage, ensuring free airflow.
A significant risk for an unconscious person is aspiration, which occurs when stomach contents, blood, or other fluids are accidentally inhaled into the lungs. This can lead to choking or serious lung infections like aspiration pneumonia. By positioning the person on their side with their mouth angled downwards, the recovery position facilitates fluid drainage, lowering the risk of aspiration.
Step-by-Step Guide to the Recovery Position
Before moving an unconscious person, always check for responsiveness by gently tapping them and asking if they are okay. If there is no response, assess their breathing by looking for chest rise and fall, listening for breaths, and feeling for air on your cheek for no more than 10 seconds. If they are breathing normally, kneel at their side and begin by straightening both their arms and legs. Remove any bulky items from their pockets or glasses.
Extend the arm closest to you straight out from their body at a right angle, palm facing upwards. Bring the other arm across their chest and place the back of their hand against the cheek closest to you, holding it in place. This arm will help support their head as you roll them.
Bend the leg farthest from you at the knee, so their foot is flat on the floor. While supporting their head and neck with the hand on their cheek, use your other hand to pull on the bent knee, gently rolling the person onto their side towards you. The extended arm prevents them from rolling too far, and the bent leg helps stabilize their body.
Once they are on their side, adjust the top leg so both the hip and knee are bent at right angles to further stabilize the position. Gently tilt their head back and lift their chin to ensure their airway remains open and any fluids can drain freely from their mouth. For infants, lay them face down over your arm at a slight angle, with their head slightly lower than their body to encourage drainage.
When to Use and Key Precautions
The recovery position is appropriate for individuals who are unconscious but are breathing normally and do not require chest compressions or CPR. This includes situations such as heat stroke, opioid toxicity or overdose, poisoning (including alcohol poisoning), or after a seizure when the person is unconscious or semi-conscious. It is also used post-cardiac arrest once circulation has spontaneously returned and the person is breathing on their own.
It is important to exercise caution and avoid moving someone into the recovery position if a spinal cord, head, or neck injury is suspected. In such cases, moving the person could worsen their condition. If an airway obstruction occurs in a person with a suspected spinal injury, manual airway management, such as gently lifting the jaw without moving the neck, is preferred until emergency services arrive.
If the person’s original position causes an airway blockage and you cannot stay with them, the recovery position may be necessary even with a suspected spinal injury. In such instances, stabilize the head, neck, and spine as much as possible while moving them. Continuously monitor their breathing and overall condition until medical help arrives, and if possible, roll them to the opposite side every 30 minutes to relieve pressure on the bottom arm.