It is vital that people understand how and when to put someone into the recovery position and re-positioning someone can often save their life.
When you are unconscious/unresponsive most of your muscles relax and go floppy. Your tongue is a huge muscle attached to your bottom jaw. If you are unconscious and lying on your back, the back of your tongue will flop back and block your airway, making you unable to breathe. In addition, your oesophagus (the tube from your throat to your stomach) and the sphincter (valve at the top of your stomach) relax and remain open. This means the contents of your stomach may trickle up and drip into your lungs. This is called passive vomiting.
To open someone’s airway (lifting the tongue from the back of the throat)
Tilt the head and lift the chin. Try this yourself; you will find that if your head is all the way back and you push your chin forward, you are unable to swallow.
Never try and pull someone’s tongue or put your fingers down to clear an airway.
Tilting their head and lifting their chin forward will automatically move their tongue away from the back of their throat so their airway is clear.
If the person is unresponsive and breathing, the only way to keep their airway open and clear without artificial airways and suction, is to put them on their side (in the recovery position). This enables their tongue to flops forward and any vomit is able to drain from their mouth.
Breathing normally / vs Agonal gasps
Just after their heart ‘stops’, a casualty may appear to be breathing when they are not. These breaths are called “agonal gasps” and are a reflex action from the lungs, not effective breathing. If there are less than 2 breaths in a 10 second period, the person is not breathing sufficiently, and you will need to start CPR.
If in doubt, always start CPR; it is better to try and resuscitate someone unnecessarily than not to resuscitate someone that has stopped breathing.
Tilt their head and lift their chin to open the airway. Then place the side of your face above their mouth and nose and look down the body to check for breathing. Look for movement of the chest, listen for the sound of breathing and feel their breath on your cheek for up to 10 seconds and you should see at least 2 breaths.
Unresponsive and Breathing
If someone is unconscious but you’re sure they are breathing normally; the best way to keep the airway open is to roll them onto their side, in the recovery position. This will encourage their tongue to flop forward and allow the contents of their stomach to drain.
Ideally, the casualty should not be on their front as this puts the weight of their body on their lungs and it is not as easy to breathe. To avoid this, bend their knee to 90 degrees in order to support them on their side. Once they are in the recovery position, keep checking they are breathing by holding the back of your hand in front of their mouth.
It is important that the head is angled over sufficiently to allow any vomit to drain. Providing there is no possibility of a spinal injury, once on their side, tilt the head back slightly to further open the airway.
8 simple steps
The following method shows you how to put someone into the recovery position if you are on your own – even if you think they could have a spinal injury.
1. Move the arm closest to you out of the way.
2. Use your hand which is closest to their head to hold their other hand and put this onto the side of their cheek to support the head and neck as you turn them
3. Use your other hand to lift up the outside of their knee.
4. Use this as a lever to pull them over.
5. Pull the knee to the floor, whilst supporting their head and neck with your other hand.
6. Pull their bent knee upwards into a running position to stabilise their body. Ensure they are over enough to make their tongue flop forward and allow the contents of their stomach to drain out. Ideally, the casualty should not be on their front as this puts the weight of their body on their lungs and it is not as easy to breathe. To avoid this, bend their knee to 90° to support them on their side
If you are not worried about a possible spinal injury, tilt their head back slightly to ensure the airway is properly open. If you are worried about a possible neck injury, just ensure they are rolled over enough to drain.
7. Get the emergency services on the way if they haven’t been called before.
8. Keep checking that they are breathing using the back of your hand to fell their breath
First Aid for Life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information. It is strongly advised that you attend a first aid course or do one online to understand what to do in a medical emergency.
Introducing a comprehensive guide to accident prevention and treatment in the older generation; Slips, Trips and Fractured Hips by Emma Hammett RGN. This book has been written for people caring for older friends and relatives; children caring for elderly parents, for spouses, for older people wanting to keep themselves that bit safer and for anyone working with or caring for older people. It is designed to help you take measures to prevent life-threatening injuries and help you plan, prepare and avoid mishap, as well as equip you with the necessary skills should an accident occur.