In first aid, the recovery position (is often used for unconscious but breathing casualties.
An unconscious person, on their back may not be able to maintain an open airway as a conscious person would. This can lead to an obstruction of the airway, restricting the flow of air which causes hypoxia.
The recovery position is designed to prevent suffocation through obstruction of the airway, which can occur in unconscious supine patients. The supine patient is at risk of airway obstruction from two routes:
- Mechanical obstruction: In this instance, a physical object obstructs the airway of the patient. In most cases this is the patient's own tongue, as the unconsciousness leads to a loss of control and muscle tone, causing the tongue to fall to the back of the pharynx, creating an obstruction. This can be controlled (to an extent) by a trained person using airway management techniques.
- Fluid obstruction: Fluids, usually vomit, can collect in the pharynx, effectively causing the person to drown. The loss of muscular control which causes the tongue to block the throat can also lead to the stomach contents flowing into the throat, called passive regurgitation. Fluid which collects in the back of the throat can also flow down into the lungs. Another complication can be stomach acid burning the inner lining of the lungs, causing aspiration pneumonia.
Placing a patient in the recovery position allows gravity to help clear of physical obstruction of the airway by the tongue, and gives a clear route by which fluid can drain from the airway.
The International Liaison Committee on Resuscitation does not recommend one specific recovery position, but advises on six key principles to be followed:
- The casualty should be in as near a true lateral position to allow free drainage of fluid.
- The position should be stable.
- Any pressure of the chest that impairs breathing should be avoided.
- It should be possible to turn the victim onto the side and return to the back easily and safely, having particular regard to the possibility of cervical spine injury.
- Good observation of and access to the airway should be possible.
- The position itself should not give rise to any injury to the casualty.