Putting someone in the recovery position ensures that their airway is clear and open. Additionally, it means that they will not choke on fluid or vomit in their mouth.
If you are sure that someone is unconscious (unresponsive) and breathing, the only position to help them maintain an open airway is the recovery position. This keeps the tongue off the back of their throat and allows any vomit to drain.
This guide explains why the recovery position saves lives, how to open someone’s airway and check their breathing, and exactly how to put an adult, child or baby into the recovery position if you are on your own, even if you think they could have a spinal injury.
What happens when someone is unconscious?
When you become unconscious or unresponsive, most of your muscles relax and become floppy.
The tongue: your tongue is a huge muscle attached to your bottom jaw. If you are unconscious and lying on your back, your tongue will flop back and block your airway, and you won’t be able to breathe.
The stomach: your oesophagus (the tube from your throat to your stomach) and the sphincter (the valve) at the top of your stomach relax and remain open. This allows the contents of your stomach to trickle up and potentially drip into your lungs. This is known as passive vomiting and is extremely dangerous to the casualty.
If someone is unconscious but breathing and lying on their back, the back of their tongue will flop to the back of their throat and the contents of their stomach will drain upwards, and they will die. They therefore need to be quickly rolled into the recovery position. This is why it is vitally important you protect the casualty’s airway.
If you suspect their unconsciousness may be due to a blow to the head, it’s important to know the warning signs of serious head injury and when to seek urgent help.
How to open someone’s airway
Tilt the head and lift the chin. Try this yourself: if your head is all the way back and you push your chin forward, you will find you are unable to swallow.
To open their airway, put one hand on their head and the other under their chin, then tilt their head back, lifting their chin upwards. This lifts their tongue away from the back of their throat so that their airway clears.
Never try to pull someone’s tongue or put your fingers down their throat to clear their airway. This is dangerous and could cause serious harm.
How to check they are breathing
Hold the airway open, then look, listen and feel to check they are breathing. You need at least 2 breaths in a 10 second period to be sure that they are breathing normally.
Be aware of 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. Agonal gasps are not effective breathing.
If there are fewer than 2 breaths during a 10 second period, the person is not breathing sufficiently and you will need to start CPR.
How the recovery position works
If the casualty is unresponsive and breathing normally, put them in the recovery position.
The role of gravity: the recovery position is simply rolling someone onto their side. This allows gravity to help their tongue flop forward and the contents of their stomach to drain out, keeping the airway clear and allowing the casualty to keep breathing.
Proper positioning: ideally the casualty should not be on their front, as this puts the weight of their body on their lungs and makes it harder for them to breathe. With an adult or child, the upper knee is bent up at 90º, in a running position, to support them on their side.
It is important that the head is over sufficiently to allow them to drain. Once you have ruled out a possible spinal injury, tilt the head back slightly once they are on their side to further open the airway and allow saliva and vomit to drain freely.
If they are already on their front: if the person has collapsed on their front and you are worried about a spinal injury, leave them as they are, provided you are sure they are breathing and their airway is not compromised.
How to put an adult or child into the recovery position
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.
- Not worried about a spinal injury, or they are very heavy? You can just use their knee as a lever to propel them over into a draining position. There is no need to support their head and neck.
- Worried about a spinal injury and have other people to help? It is best to log roll them to keep the spine in line.
Step 1: Position the arms. Move the arm closest to you out of the way. Use the hand 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.
Step 2: Prepare to roll. Use your other hand to lift up the outside of their knee. Use this as a lever to pull them over.
Step 3: Roll them over. Pull the knee to the floor, whilst supporting their head and neck with your other hand.
Step 4: Stabilise and open the airway. Pull their bent knee upwards into a running position to stabilise their body. Ensure that they are over enough that their tongue is flopping forward and any contents of their stomach are able to drain out of their mouth. 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.
Step 5: Monitor the casualty. Keep checking that they are breathing by feeling their breath on the back of your hand. Get the emergency services on the way if they haven’t already been called.
How to put a baby into the recovery position
For a baby, you have two options.
Option 1: Hold them in your arms. Hold the baby in your arms, on their side, with their head lower than their stomach. Put the back of your hand under their mouth and nose to keep checking that they are breathing. If you are unsure, wet the back of your hand as it makes it more sensitive. Call an ambulance.
Option 2: Lay them on a blanket or coat. Roll them into the recovery position on a blanket or coat to insulate them from the ground. Use a rolled-up jumper or something similar to keep them on their side. Keep checking that they are breathing. Call an ambulance.
Once they are in the recovery position
Keep checking that they are breathing by feeling their breath with the back of your hand in front of their mouth. Make sure the emergency services are on their way. If they stop breathing normally, roll them onto their back and start CPR.
About us
It is strongly advised that you attend a Practical or Online First Aid course to understand what to do in a medical emergency. It is vital to keep your skills current and refreshed.
First Aid for Life is a multi-award-winning, fully regulated first aid training provider, approved through Qualsafe Awards to deliver Ofqual-regulated qualifications. Our trainers are highly experienced medical, health and emergency services professionals who will tailor the training to your needs. We provide courses for groups or individuals, at our venue or yours, across the UK.
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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.
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