For many years, healthcare professionals have been taught to place unconscious but breathing patients in the safety lateral (SLC) position. This is done to prevent vomit and/or stomach contents from reaching the lungs. When this happens, it is known as aspiration.
In medical terms, the recovery position is called the lateral decubitus position. In almost all cases, first aid professionals are advised to place the patient on their left side, which is called the left lateral recumbent position.
In the recovery position, the patient is placed on one side with the far leg bent at an angle. The far arm is placed across the chest with the hand on the cheek. The goal is to prevent aspiration and help keep the patient’s airway open. The position also keeps the patient still until emergency personnel arrive.
Steps to the safety lateral position
First you have to make sure the scene is safe. If so, the next step is to call 112 and then check if the patient is conscious or breathing. At this point, we should also look for other serious injuries, such as to the neck. If the patient is breathing but not fully conscious and has no other injuries, we may place the patient in the recovery position while we wait for emergency personnel.
If an unconscious patient is not breathing, we must clear the airway before placing him in a recovery position.
To place a patient in the recovery position:
- We will kneel next to the person. We’ll make sure he’s on his back and stretch out his arms and legs.
- We will take the arm closest to us and fold it over the chest.
- We will take the arm farthest from us and extend it away from the body.
- We will bend the leg closest to us at the knee.
- We will support the patient’s head and neck with one hand. We will hold the bent knee and move the person away from us.
- We will tilt the patient’s head back to keep the airway clear and open.
The recovery position is used a lot in first aid situations, but there are some situations where it is not suitable. In some cases, moving a patient on their side or moving them at all could make their injury worse. Using the recovery position (PLS) is not recommended if the patient has a head, neck, or spinal cord injury.
If the baby is unconscious, breathing, and has a pulse (does not need CPR), we will place the baby in a recovery position until a healthcare professional arrives. The recovery position prevents the child from choking while unconscious. For children under 1 year:
- We will place the baby face down on the forearm.
- We will make sure to support the baby’s head with your hand.
The goal of using the recovery position is to allow whatever is regurgitated to drain through the mouth. The top of the esophagus (food tube) is right next to the top of the trachea. If material leaves the esophagus, it could easily reach the lungs. This could effectively choke the patient or cause what is known as aspiration pneumonia, which is an infection of the lungs caused by foreign material.
Previously, the recovery position on the left side was preferred. However, recent research suggests that, in most cases, it probably doesn’t matter which side a person is on.
Unfortunately, there isn’t much evidence that the safety side position works or doesn’t work. This is because the science so far has been limited.
A 2016 study looked at the relationship between recovery position and hospital admission in children between 0 and 18 years old diagnosed with loss of consciousness. The study found that children who were placed in the recovery position by caregivers were less likely to be admitted to hospital.
Another study found that placing cardiac arrest patients in the recovery position could prevent bystanders from noticing if they stop breathing. This could cause a delay in the administration of CPR.
Research has also found that patients with a form of heart disease called congestive heart failure do not tolerate the left-sided recovery position well. Despite limited evidence, experts still recommend placing unconscious patients in the recovery position, although they also note that signs of life should be continuously monitored.
how to help someone
The lateral safety position is useful in certain situations, sometimes with adjustments depending on the circumstance.
- Overdose . There is more to an overdose than the risk of aspiration of vomit. A patient who swallowed too many pills may still have undigested capsules in the stomach. Science suggests that the safety side position may help decrease the absorption of certain medications. This means that someone who has overdosed may benefit from being placed in the recovery position on the left side until help arrives.
- seizure . It is recommended to wait until the seizure is over before placing the person in the recovery position. We will call 112 if the person was hurt during the seizure or has trouble breathing afterward. We will also call the experts if it is the first time the person has had a seizure or if it lasts longer than normal for them. Seizures that last more than five minutes or multiple seizures that occur in quick succession are also reasons to seek emergency care.
- After CPR . After someone receives CPR and is breathing, your main goals are to make sure the person is still breathing and that nothing remains in the airway if they vomit. That may mean putting them in the recovery position or face down. Make sure to monitor breathing and that you can access the airway if you need to clean objects or vomit.