Recovery Position

In this lesson, you'll learn how to safely use the recovery position, for those times when you encounter a patient who is breathing but unconscious.

The recovery position is used in the following scenario:

• The patient is unresponsive
• The patient is breathing normally
• The patient has good skin color, good circulation
• It's not an immediate CPR situation

How to Put a Patient into the Recovery Position

As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim.

In this situation the patient is unresponsive to your taps and shouts, which elicits an immediate 911 call and finding and/or preparing an AED for use, as you begin to assess the scene for clues of what happened.

The patient could have ended up unconscious for a number of reasons:

• Passed out or fainted
• Suffering from low blood sugar
• Seizure
• Electrocution

To help keep the patient's airway open and clear, put them into the recovery position using the following steps:

1. Elevate the arm closest to you and bring it up over the patient's head before placing it on the ground.
2. Bring the patient's furthest leg over their other leg so that their legs are crossed.
3. Grab the wrist of the furthest arm and the hip together, while placing your other hand under the head and neck and roll the patient toward you and onto their side.
4. Support the head while you place the patient's outstretched arm under their own head and with the chin pointing down, allowing gravity to help clear the airway.
5. Bend the patient's top leg to a 90-degree angle at the knee, essentially creating a kickstand to help protect the patient from rolling over.

The recovery position is also a great way for the patient to lay safely while waiting for EMS. Using the patient's leg as a kickstand allows his or her body to use gravity without the threat of them rolling completely over.

Continue to reassess the patient while you wait for EMS to respond, particularly for signs of shock, responsiveness, airway, breathing, and circulation. And treat accordingly should the situation change.

A Word About the Signs of Inadequate Breathing

Inadequate breathing requires careful monitoring. You may not notice all of the signs and symptoms at once, and some can be hard to spot. If you see any of them, be prepared to give assisted ventilation.

When the patient has to expend too much effort to breathe and their breathing has become inadequate, you'll notice the following signs:

• Muscles between the ribs pull in when the patient breathes in. As the patient enhales, you may notice the muscles pulling inward between the ribs, above the collarbone, around the muscles of the neck and below the rib cage.
• Pursed lips breathing. The patient exhales through pursed lips, like a whistling motion. This maneuver helps control the patient's breathing pattern.
• Flaring out of the nostrils on inhalation can be a sign of inadequate breathing in children and infants.
• Apparent signs of fatigue are also an indication of labored breathing.
• Excessive use of abdominal muscles to breathe, as in when the patient is using the abdominal muscles to force air out of the lungs.
• Sweating and anxiousness are also signs of severe respiratory distress.
• A patient who is sitting upright and leaning forward with hands on knees could be doing so because they're struggling to breathe.

Abnormal breathing sounds are also a great sign of inadequate breathing. Listen for abnormal sounds such as wheezing or crackling. Wheezing or whistling sounds indicate restricted air flow and are common with conditions such as asthma, allergic reactions, and emphysema. If the patient has a fine cracking sound on inhalation, that may indicate fluid in the lungs.