What is the recovery position?

Recovery Position

The recovery position is a life-saving positioning technique used to maintain an open airway in unconscious but breathing victims by placing them on their side to prevent airway obstruction and aspiration of fluids. 1

Definition and Purpose

The recovery position is designed to:

• Maintain an open airway in unconscious patients 1
• Prevent aspiration of fluids or vomit 1
• Allow drainage of secretions from the mouth 1
• Prevent the tongue from blocking the airway 1

Standard Recovery Position Technique

According to the European Resuscitation Council guidelines, the recovery position should be performed as follows:

1. Initial Assessment:

   • Check if the victim is responsive 1
   • Open the airway by tilting the head and lifting the chin 1
   • Verify normal breathing 1

2. Positioning Steps:

   • Remove the victim's spectacles 1
   • Kneel beside the victim and ensure both legs are straight 1
   • Open the airway by tilting the head and lifting the chin 1
   • Place the arm nearest to you out at right angles to the body, elbow bent with the hand palm uppermost 1
   • Bring the far arm across the chest, and hold the back of the hand against the victim's nearest cheek 1
   • With your other hand, grasp the far leg just above the knee and pull it up, keeping the foot on the ground 1
   • Keeping the hand pressed against the cheek, pull on the leg to roll the victim toward you onto their side 1
   • Adjust the upper leg so both hip and knee are bent at right angles 1
   • Tilt the head back to ensure the airway remains open 1
   • Adjust the hand under the cheek if necessary to keep the head tilted 1
   • Check breathing regularly 1

Important Considerations

Monitoring Requirements

• Check breathing regularly after placing the victim in the recovery position 1
• Monitor the peripheral circulation of the lower arm to prevent pressure-related complications 1
• Minimize the duration of pressure on the dependent arm 1

Special Circumstances

For Suspected Neck Injuries:

• Consider using the HAINES modified recovery position (High Arm IN Endangered Spine) 2
• This modification involves raising one of the patient's arms above the head in full abduction to support the head and neck 2
• The HAINES position results in less cervical spine movement compared to the standard recovery position 2

Potential Complications

• The recovery position may hinder breathing evaluation and delay detection of cardiac arrest 3, 4
• Studies show that continuous head-tilt-chin-lift technique may allow better breathing assessment than the recovery position 4
• The recovery position may cause obstructed venous return in the dependent arm 5

When to Use the Recovery Position

• Use for unconscious but normally breathing victims 1
• Do not use for victims who are not breathing normally, as they require immediate CPR 1
• For trauma victims with suspected neck injuries, consider the modified HAINES position 2

Importance of Regular Reassessment

• When using the recovery position, breathing should be checked regularly 1
• Studies suggest that re-evaluating breathing every minute significantly increases the likelihood of detecting cardiac arrest compared to less frequent checks 3
• If breathing becomes abnormal or stops, immediately roll the victim onto their back and begin CPR 1

Despite potential complications during training and use, placing an unconscious, breathing victim into the recovery position can be life-saving by maintaining airway patency and preventing aspiration 1.