The recovery position is a fundamental first-aid technique used to stabilize an unresponsive person until professional medical help arrives. This posture is designed to protect a person who is unconscious but still breathing. Knowing when and how to correctly place someone in this position is essential for maintaining their immediate safety. The procedure focuses on managing the two greatest risks faced by an unconscious person lying on their back.
Understanding the Function of the Recovery Position
The primary physiological reason for the recovery position is to maintain a clear and open upper airway. When a person is unconscious, the muscles throughout their body relax, including the tongue and the epiglottis. Lying on the back allows the tongue to fall backward and potentially obstruct the throat, a common cause of airway restriction in an unresponsive individual.
The side-lying posture uses gravity to pull the tongue forward, preventing it from blocking the windpipe. A side position also allows any fluids within the mouth—such as saliva, blood, or stomach contents from vomiting—to drain outwards. This drainage reduces the risk of aspiration, a dangerous condition where foreign substances are inhaled into the lungs, which can lead to severe complications like aspiration pneumonia.
Key Indicators for Patient Repositioning
The decision to use the recovery position is based on two absolute criteria: the person must be unresponsive and they must be breathing normally. Unresponsiveness means the person does not react to voice or touch, such as shouting their name or gently tapping their shoulder. An unresponsive person cannot regulate their own airway, making the recovery position necessary for safety.
The presence of normal breathing is the second indicator, distinguishing this situation from cardiac arrest. If a person is not breathing or is exhibiting abnormal, gasping breaths—often called agonal breathing—Cardiopulmonary Resuscitation (CPR) is required instead. Common scenarios where this position is appropriate include unconsciousness resulting from intoxication, post-seizure activity, or fainting where consciousness has not yet returned.
Step-by-Step Instructions for Safe Placement
The standard maneuver for placing an adult involves careful, sequential steps. First, kneel beside the patient and ensure both legs are straight, removing any spectacles or bulky items. The arm nearest to the rescuer is placed out at a right angle to the body, with the elbow bent and the palm facing upward. This arm will act as a stabilizer once the patient is rolled.
Next, the patient’s far arm is brought across their chest, and the back of that hand is placed against the cheek nearest to the rescuer. The far leg is then grasped just above the knee and pulled up, keeping the foot flat on the ground. Using the bent leg and the hand against the cheek, the patient is gently rolled toward the rescuer onto their side.
The final adjustments ensure stability and airway patency. The top leg should be adjusted so the hip and knee are bent at right angles to prevent rolling. The head is then gently tilted back with the chin lifted to confirm the airway is open, using the hand under the cheek for support. Continuous monitoring of the patient’s breathing is required until emergency services arrive.
Situations Where Movement is Contraindicated
There are specific exceptions where moving a patient into the recovery position must be avoided, primarily when a spinal or severe head injury is suspected. If the cause of unconsciousness is a fall from a height, a car accident, or any crushing injury, it is safest to assume a spinal injury is present. In these instances, maintaining spinal stabilization takes precedence, and the patient should be left in the position they were found to prevent exacerbating a potential neck or back injury.
The only exception is if the patient’s airway is actively obstructed or if they stop breathing normally. If movement is necessary to clear the airway or begin CPR, the rescuer must attempt to keep the head, neck, and spine in a straight line while carefully rolling the patient.