The scenario of an unresponsive person vomiting presents an immediate, severe threat to life due to the risk of aspiration. Aspiration occurs when stomach contents are accidentally inhaled into the lungs, potentially leading to airway blockage and chemical pneumonitis. Unconsciousness inactivates protective reflexes, such as the cough and gag reflex, causing the airway to lose its natural defense. Immediate action is necessary to protect the person’s breathing and circulation until professional medical help arrives.
Prioritizing Professional Help
Summoning emergency medical services (EMS) must be the first priority, initiated the moment you recognize the person is unresponsive. Have a bystander call 911 or the local emergency number while you begin providing aid. When speaking to the dispatcher, clearly state the exact location and the person’s status, specifically mentioning the unresponsiveness and the presence of vomit. This information allows the dispatch center to send the appropriate level of response. The dispatcher will often provide instructions, and you should remain on the line with them until professional help arrives.
Safe Positioning to Prevent Aspiration
The single most effective action to prevent aspiration is moving the person into the recovery position, which leverages gravity for drainage. This position ensures the tongue falls forward, preventing airway blockage, and directs fluid out of the mouth rather than into the trachea.
Kneel beside the person and ensure both legs are straight. Position the arm closest to you straight out at a right angle, with the elbow bent and palm facing up; this arm acts as a stabilizing support when the person is rolled.
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 to support the head during the roll. Bend the leg farthest from you at the knee, placing the foot flat on the ground to create a lever.
Use the bent knee to gently roll the person toward you onto their side in one fluid motion. The bent knee and the outstretched arm stabilize the body, preventing them from rolling onto their stomach or back.
The person’s head must be tilted slightly back with the mouth pointing downward to facilitate the unimpeded drainage of vomit and saliva. This head placement keeps the airway open and allows material to exit the mouth. You must constantly monitor the person to ensure they do not shift out of the correct alignment.
Airway Clearing and Continuous Monitoring
Once the person is safely positioned on their side, quickly assess the mouth for any large, visible foreign material that could obstruct the airway. Use a finger, preferably covered with a cloth or glove, to gently sweep the mouth and remove accessible debris. Only attempt a finger sweep if the material is visible and within easy reach, as blindly sweeping risks forcing the obstruction further into the airway.
After clearing the mouth, wipe the face and mouth to remove residual vomit, then check for normal breathing. Listen and feel for air movement near their mouth and nose, while observing the chest for rhythmic rising and falling. If the person is breathing, continue to monitor the rate and depth of breaths closely, ensuring the recovery position is maintained.
If the person stops breathing or their breathing becomes ineffective (e.g., only gasping or gurgling sounds), immediately transition to cardiopulmonary resuscitation (CPR). Roll the person onto their back and begin chest compressions. Continue monitoring the person until EMS arrives and takes over care.