How do I put someone in the recovery position?
Why an unconscious person on their back is at risk, the sequence for rolling them onto their side, and what to watch for once they are there.
- Difficulty
- beginner
- Time
- 6 min
- Read
- 4 min
- Safety
- warning
Short answer
Use it when someone is unresponsive but breathing normally. Kneel beside them, put the near arm out at a right angle with the elbow bent, bring the far hand to their cheek, pull the far knee up, then pull on that knee to roll them towards you. Tilt the head back to keep the airway open. Ring 999, stay with them, and keep checking that they are still breathing.
An unconscious person lying on their back is at risk from their own tongue and from anything in their mouth, because the reflexes that normally protect the airway are switched off. The recovery position uses gravity to solve both problems at once, and it takes about fifteen seconds once you have done it before.
Safety
Step by step
- Confirm they are breathing normally first.Unresponsive but breathing normally is the situation this is for. If they are not breathing, or are only making occasional gasps, they need chest compressions and 999 immediately instead.
- Kneel beside them and straighten their legs.Kneel at their side with room to roll them towards you. Remove glasses, and anything bulky in the pocket you will be rolling them onto.
- Place the near arm out at a right angle.The arm nearest you goes out from the body at roughly a right angle, elbow bent, palm facing upwards.
- Bring the far hand to the near cheek.Take their far arm across their chest and hold the back of that hand against the cheek nearest you. Keep your hand there — it supports the head through the roll.
- Pull the far knee up.With your other hand, grasp the far leg above the knee and pull it up so the foot is flat on the ground. That leg is your lever.
- Roll them towards you.Pull steadily on the raised knee to roll them onto their side, keeping their hand against their cheek as they come. Adjust the upper leg so both hip and knee are bent at right angles, which stops them rolling further.
- Open the airway again.Gently tilt the head back and lift the chin so the airway stays open and anything in the mouth can drain out. This is the whole purpose of the position, so do not skip it.
- Call 999 and stay.If it has not been done already, ring for an ambulance. Then stay and keep checking that they are still breathing normally, because that can change at any time.
- Swap sides after about thirty minutes.If they are still in the position after roughly half an hour and help has not arrived, roll them onto the other side to relieve pressure on the lower arm.
Tips
- Practise this once on a willing adult. It takes two minutes to learn and it is far harder to do for the first time under pressure.
- Cover them with a coat or a blanket if you are outdoors. An unconscious person loses heat quickly and cannot do anything about it.
- Note the time they became unconscious if you can. It is one of the first things the ambulance crew will ask.
Common mistakes
- Using the recovery position on someone who is not breathing — It delays the only thing that helps, which is chest compressions. The breathing check is what separates the two situations and it comes first.
- Leaving them alone once they are on their side — Their condition can deteriorate, and someone who stops breathing needs CPR started immediately. The position buys time; it does not fix anything.
- Forgetting to tilt the head back afterwards — Rolling someone onto their side without opening the airway leaves the tongue where it was. The head tilt is the part that does the work.
- Giving them a drink because they seem to be coming round — Someone who has been unconscious may not be able to protect their own airway. Nothing by mouth until they are fully awake and the ambulance crew say otherwise.
If it doesn't work
They start to vomit
Cause: Common after a collapse, a seizure or intoxication — Fix: This is exactly what the position is for. Keep them on their side, keep the airway open, and let it drain.
You cannot roll them because of their size or the space
Cause: A confined space, or a size difference — Fix: Do what you can to keep the airway open and the head turned to one side, and tell the 999 handler. They will give you the best option for the situation you are actually in.
They have had a seizure and are now unresponsive
Cause: The drowsy postictal phase after a seizure, which is normal — Fix: Once the seizure has stopped, if they are breathing normally, put them in the recovery position and stay with them. Follow the NHS guidance on when a seizure needs 999 — a first seizure, one lasting more than five minutes, or repeated seizures all do.
Questions people ask
What about a suspected spinal injury?
An open airway takes priority over everything, including a possible spinal injury, because an obstructed airway kills within minutes. Where you can, keep the head, neck and spine aligned as you roll, and follow the 999 handler's instructions.
Which side should they be on?
Either, for a general casualty — roll them towards you, whichever side that is. The exceptions are specific: NHS guidance for anaphylaxis in pregnancy, for example, is to lie on the left side.
Can I use it on a child or a baby?
The principle is the same for a child. For a baby under one, the usual advice is to hold them on their side with the head tilted slightly downwards so anything in the mouth drains. Ring 999 and follow the handler.