The recovery position
Roll someone who is unresponsive but breathing normally onto their side so their airway stays open, then keep watching their breathing.
WHY THE SIDE
On the back, the airway can close; on the side, it drains
An unconscious person lying on their back can have their airway blocked by their own tongue falling back, or by vomit or blood they can't clear. Rolled onto their side, with the head tilted back and the mouth angled down, the tongue falls forward and fluids drain out of the mouth instead of into the lungs. It also keeps them stable, so they don't roll back while you're on the phone.
Holding a head tilt with your hands works too, but only while you stay kneeling there. The recovery position holds the airway open by itself.
Check yourself
Who should you put in the recovery position?
- Anyone who has fainted, even if they're now awake and talking
- Someone who is unresponsive and taking an occasional gasp
- Someone who is unresponsive and breathing normally
- Someone who is awake but has a bad headache
Show the answer
Someone who is unresponsive and breathing normally
Yes. Unresponsive and breathing normally is exactly who it's for. Occasional gasps mean not breathing normally, which calls for CPR instead.
Rolling someone into the recovery position
- Kneel beside them and clear their pockets
They're on their back. Take off their glasses and remove bulky things from their pockets, like keys or a phone.
- Near arm out, at a right angle
Put the arm nearest you out at a right angle to their body, elbow bent, palm facing up.
- Far hand to the near cheek
Bring the far arm across their chest and hold the back of that hand against their cheek on your side. Keep it there.
- Far knee up
With your other hand, pull the far knee up so that foot is flat on the ground.
- Roll them towards you
Pull on that raised knee to roll them towards you onto their side, while the hand stays pressed against the cheek.
- Adjust the leg and the head
Set the top leg so the hip and knee are both at right angles. Tilt the head back to keep the airway open, with their hand under the cheek and the mouth angled down so fluids can drain.
Check yourself
Put the moves in order: match each one to its place
Show the answer
- Near arm out at a right angle, palm up → 1st
- Back of the far hand against the near cheek → 2nd
- Far knee up, foot flat → 3rd
- Pull the knee to roll them towards you → 4th
- Top leg at right angles, head tilted back → 5th
Once they're on their side
- Make sure the emergency number has been called, if it hasn't been already.
- Keep checking that they're breathing normally, the whole time, not once. Breathing can change.
- If breathing stops or becomes abnormal: roll them onto their back, call again if needed, and start CPR.
- If they stay in the position a long time (UK guidance says after about 30 minutes), turn them onto the other side to take pressure off the lower arm.
- Keep them warm, give nothing to eat or drink, and stay with them.
Check yourself
Reza has been in the recovery position for a few minutes while the ambulance is on its way. Sara, watching him, notices his breathing has stopped. What should she do?
- Leave him on his side and wait for the ambulance
- Roll him onto his back, make sure 115 knows, and start CPR
- Turn him onto his other side
- Sit him up to help him breathe
Show the answer
Roll him onto his back, make sure 115 knows, and start CPR
Right. Once he's not breathing normally, the recovery position no longer fits. On his back, call (or tell the dispatcher if she's still on the line) and start CPR.
SPECIAL CASE
A pregnant woman: her left side
If an unresponsive pregnant woman is breathing normally, place her on her left side. Lying on her back, the weight of the womb can press on a major vein and reduce the blood returning to her heart. The left side takes that weight off.
Maryam, seven months pregnant, faints in a hot queue and doesn't respond, but breathes normally. Her sister rolls her onto her left side and calls 115.
Check yourself
An unresponsive pregnant woman who is breathing normally is best placed on her left side.
Show the answer
True
True. On her left side, the womb's weight is taken off a major vein, so more blood can return to her heart. Then keep checking her breathing like anyone else.
SPECIAL CASE
A possible neck or back injury
After a fall from a height, a road crash or a diving accident, the neck or spine may be hurt, and moving them could make it worse. If they're breathing normally on their back and the airway is clear, you can keep them still and hold the head steady while you wait. But an open airway comes first: if they may vomit, the airway is at risk, or you have to leave them to get help, roll them carefully, keeping the head, neck and body in a line.
A body can recover from many injuries. It can't wait long without air.
Check yourself
- Daniyal falls from a ladder in the garden and doesn't respond. He lies on his back, breathing normally and quietly. Parisa kneels at his head, holds it still and waits for the ambulance.
- Daniyal falls from the same ladder and doesn't respond. He's breathing, but starts to make gurgling sounds as if he's about to vomit. Parisa rolls him onto his side, keeping his head, neck and body in line.
Both times a neck injury is possible. Why did Parisa roll him in the second case?
- Because he had been lying still too long
- Because his airway was now at risk, and an open airway comes before protecting the neck
- Because the ambulance was taking too long
- Because a fall from a ladder never injures the neck
Show the answer
Because his airway was now at risk, and an open airway comes before protecting the neck
Exactly. While the airway is clear, keeping him still protects the neck. Once he may vomit, the airway wins, so she rolls him, carefully and in line.
Lesson recap
- The recovery position is for someone unresponsive and breathing normally, never for someone who is only gasping.
- On the side, the tongue falls forward and fluids drain from the mouth, so the airway stays open by itself.
- The roll: near arm out, far hand to cheek, far knee up, roll towards you, then top leg at right angles and head tilted back.
- Keep checking breathing the whole time. If it stops or turns abnormal: onto the back, call, CPR.
- Pregnant: left side. Possible neck injury: keep still if the airway is clear, but roll in line if the airway is at risk. An open airway comes first.