Recovery position

Recovery Position

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Recovery position

The recovery position or more technically known as the lateral recumbent position is a first aid

First aid

Unconsciousness

Unconsciousness, more appropriately referred to as loss of consciousness or lack of consciousness, is a dramatic alteration of mental state that involves complete or near-complete lack of responsiveness to people and other environmental stimuli....
, or nearly so, but are still breathing. It is frequently taught as part of classes in CPR (cardiopulmonary resuscitation

Cardiopulmonary resuscitation

First aid

First aid is the provision of initial care for an illness or injury. It is usually performed by a layman to a sick or injured Casualty until definitive medical treatment can be accessed....
.

When an unconscious person is lying face upwards, there are two main risk factors which can lead to suffocation:

Fluids, possibly blood but particularly vomit, can collect in the back of the throat, causing the person to drown.

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Encyclopedia

The recovery position or more technically known as the lateral recumbent position is a first aid

First aid

Unconsciousness

Cardiopulmonary resuscitation

First aid

Esophagus

The esophagus or oesophagus , sometimes known as the gullet, is an Organ in vertebrates which consists of a Muscle tube through which food passes from the pharynx to the stomach....
tilts down slightly from the stomach toward the throat. This, combined with loss of muscular control, can lead to the stomach contents flowing into the throat, called passive regurgitation. As well as obstructing the airway, fluid which collects in the back of the throat can also then flow down into the lungs; stomach acid can attack the inner lining of the lungs and cause a condition known as aspiration pneumonia

Aspiration pneumonia

Aspiration pneumonia is bronchopneumonia that develops due to the entrance of foreign materials that enter the bronchial tree, usually oral or gastric contents ....
.

Many fatalities occur where the original injury or illness which caused unconsciousness is not itself inherently fatal, but where the unconscious person suffocates for one of these reasons. This is a common cause of death following unconsciousness due to excessive consumption of alcohol.

To a limited extent, it is possible to protect against risks to the airway by tilting the head back and lifting the jaw. However, an unconscious person will not remain in this position unless held constantly, and crucially it does not safeguard against risks due to fluids. If the person is placed in the recovery position, the action of gravity will allow any fluids to drain. Also the chest is raised above the ground, which helps to make breathing easier.

When to use the Recovery Position

The recovery position is recommended for unconscious

Unconscious

Unconscious might refer to:In physiology:* unconsciousness, the lack of consciousness or responsiveness to people and other environmental stimuli....
people, those who are too inebriated to assure their own continued breathing, victims of drowning

Drowning

Drowning is death from suffocation caused by a liquid entering the lungs and preventing the absorption of oxygen leading to cerebral Hypoxia and cardiac arrest....
, and also for victims of suspected poisoning (who are liable to become unconscious). It is suitable for any unconscious person who does not need CPR

Cardiopulmonary resuscitation

Putting a victim in the Recovery Position

Before using the Recovery Position, perform the preliminary first aid steps. First assess whether the scene is safe for the rescuer. If not, leave. Assess whether the person is responsive to your voice by asking something like "hey, buddy, are you OK?". If not, assess whether the person responds to painful stimulus by rubbing their sternum

Sternum

The sternum is a long flat bone located in the center of the chest . It connects to the rib via cartilage, forming the rib cage with them, and thus helps to protect the lungs, heart and major blood vessels from physical trauma....
with your knuckles (this is not accepted practice in some countries). Assess whether the victim has an open airway, is breathing and has a pulse ("airway, breathing, and circulation" or "ABC"). If the victim is alert and an adult, obtain consent before performing first aid. For children, attempt to obtain consent from a parent, guardian, or other responsible caregiver. If the victim is not alert, and is not breathing, check for a pulse. If there is no pulse, perform cardiopulmonary resuscitation

Cardiopulmonary resuscitation

Cardiopulmonary resuscitation is an emergency medical procedure for a victim of cardiac arrest or, in some circumstances, respiratory arrest. CPR is performed in hospitals, or in the community by layman or by emergency response professionals....
. If there is circulation, perform rescue breathing. The initial assessment should be done quickly, in a minute or less. Before you perform any of this, however, alert trained emergency medical personnel. Call the emergency telephone number

Emergency telephone number

Many countries' Public switched telephone network have a single emergency telephone number, sometimes known as the universal emergency telephone number or occasionally the emergency services number, that allows a caller to contact local emergency services for assistance....
or other emergency services.

If no spinal or neck injury is indicated

The correct position is called the "lateral recovery position." Start with the victim lying on the back and with the legs straight out. Kneel on one side of the victim, facing the victim. Move the arm closest to you so it is perpendicular to the body, with the elbow flexed (perpendicular). Move the farthest arm across the body so that the hand is resting across the torso.

Bend the leg farthest from you so the knee is elevated. Reach inside the knee to pull the thigh toward you. Use the other arm to pull the shoulder that is farthest from you. Roll the body toward you. Leave the upper leg in a flexed position to stabilize the body.

Victims who are left in this position for long periods may experience nerve compression. Still, that is a more desirable outcome for the victim than choking to death.

If spinal or neck injuries are possible

When the injury is apparently the result of an accidental fall, collision or other trauma, the risk of spinal or neck injuries should be assumed. Normally, only trained medical personnel should attempt to move a victim with neck or spinal injuries. Such movements run the risk of causing permanent paralysis or other injuries.

Movement of spinal-injured victims should be minimized. Such victims should only be moved to a recovery position when it is necessary to drain vomit from the airway.

In such instances, the correct position is called the "HAINES modified recovery position." HAINES is an acronym

Acronym and initialism

Acronyms, initialisms, and alphabetisms are abbreviations that are formed using the initial components in a phrase or name. These components may be individual letters or parts of words ....
of High Arm IN Endangered Spine. In this modification, one of the patient's arms is raised above the head (in full abduction) to support the head and neck.

There is less neck movement (and less degree of lateral angulation) than when the lateral recovery position is used, and, therefore, HAINES use carries less risk of spinal-cord damage.

First Aider Notes

If an individual has suffered a fall or injuries that suggest damage to the spine, as a first aider the priority is to keep the airway open. If breathing, position should not be changed. If breathing has stopped, regardless of possible injury to the person, perform standard checks: DR & ABC (Danger, Response, Airway, Breathing, Circulation)and then move them into the recovery position to open the airway. If they do not start breathing, begin CPR. If they begin to breathe, keep them in that position.

Additional note for pregnant victims

A pregnant woman should always rest on her left side, as lying on the right side may cause the uterus to compress the Inferior vena cava

Inferior vena cava

The inferior vena cava is the large vein that carries de-oxygenated blood from the lower half of the body into the right atrium of the heart....
, possibly resulting in death.

Additional note for victims with torso wounds

A victim with torso wounds should be placed with the wounds closest to the ground to minimize the possibility of blood affecting both lungs, resulting in asphyxiation.

External links

– step-by-step description with diagrams, from Harvard Medical School – step-by-step description with diagrams, from St. John Ambulance

St. John Ambulance

St John Ambulance, branded as St John in some territories, is a common name used by a number of affiliated organisations in different countries dedicated to the teaching and practice of medical first aid and the provision of ambulance services, all of which derive their origins from the St John Ambulance in England and Wales founded in...
. – extensive text description of how to move a victim into the recovery position.