Recovery position
If your casualty is unresponsive, but breathing normally, with no evidence of major physical trauma your priority is to ensure that their airway is not compromised in any way and that it remains open. Rather than leaving them on their back or in a slumped position, an effective way of achieving this is to place them in the recovery position.
Whilst the casualty remains in this position, it will allow vomit to drain from the mouth and prevent them from rolling onto their back should you have to leave them.
- Place the arm nearest to you out at a right angle to their body, elbow bent with the hand palm-up
- Do not force the arm, let it fall naturally, but close to this position
- Bring the far arm across the chest, and hold the back of the hand against their cheek nearest to you
- Grab hold of the far leg with your other hand, and raise the knee so that their foot is kept to the floor. This will be your lever for rolling them over
- Keeping their hand pressed against their cheek, pull on the far leg to roll them towards you onto their side with their head supported all the way
- Tilt the head back to make sure that the airway remains open. If necessary, adjust the hand under their cheek to keep their mouth facing downwards to allow liquid material to drain from the mouth
- Adjust the upper leg so that both the hip and knee are bent at right angles
- Check breathing regularly
- If you have a bystander available to you this is the time to send them to call for an ambulance ensuring they have all the appropriate information, and in particular, the condition of the casualty
If you have no bystander, you must call for an ambulance yourself
If they have to be kept in the recovery position for more than 30 minutes turn them to the opposite side to relieve the pressure on the lower arm.
You must continue to monitor their breathing whilst waiting for the emergency services to take over. If they stop breathing normally you must call the emergency services with an update and commence CPR immediately.
It will also be worth monitoring and noting other changes such as colouration of the skin, their temperature and responsiveness levels.
Pregnant Women
Always put an unresponsive pregnant woman in the recovery position on her left side. This prevents compression of the inferior vena cava (large vein) by the uterus, which could be fatal for both the mother and the child.
Suspected Spinal Injury
If you suspect a spinal injury and you cannot maintain an open airway in the position you found them, care must be taken when moving them.
Keep the casualty’s back straight and support the head throughout. It would be extremely useful to have help to move the casualty with the trained person assuming control over the move.