Recovery (coma) position

Several variations of the recovery position have been described, each with its own advantages. The position should be stable, near a true lateral position with the head dependent, and with no pressure on the chest to impair breathing.

The RC (UK) recommends the following sequence of actions to place a victim in the recovery position:

• For adults and children with a decreased level of responsiveness due to medical illness or non-physical trauma, who do not meet the criteria for the initiation of rescue breathing or chest compressions (CPR), RCUK recommends they be placed into a lateral, side-lying recovery position. Overall, there is little evidence to suggest an optimal recovery position, but RCUK recommends the following sequence of actions:
  • Kneel beside the person and make sure that both legs are straight.
  • Place the arm nearest to you out at right angles to the body with the hand palm uppermost.
  • Bring the far arm across the chest, and hold the back of the hand against the person’s cheek nearest to you.
  • With your other hand, grasp the far leg just above the knee and pull it up, keeping the foot on the ground.
  • Keeping the hand pressed against the cheek, pull on the far leg to roll the person towards you onto their side.
  • Adjust the upper leg so that both the hip and knee are bent at right angles.
  • Tilt the head back to make sure the airway remains open.
  • Adjust the hand under the cheek if necessary, to keep the head tilted and facing downwards to allow liquid material to drain from the mouth.
  • Check regularly for normal breathing.
  • Only leave the person unattended if absolutely necessary, for example to attend to other people.
• It is important to stress the importance of maintaining a close check on all unresponsive individuals until the EMS (emergency services) arrives to ensure that their breathing remains normal. In certain situations, such as resuscitation-related agonal respirations or trauma, it may not be appropriate to move the individual into a recovery position.

Reference:

1. Resuscitation Council (UK). Resuscitation Guidelines 2021.