Recovery Position and Care of the Patient

Video 10 of 36
5 min 54 sec

If you come across somebody who's unconscious, there are a few things we need to do. Obviously, when we're approaching somebody we need to make sure it's safe. But we're now looking at a point we're actually at the patient's side. When we're at the patient's side, we've got an initial assessment process. We need to find out to start with if this person is breathing.

So we've approached, stop, think, act. We're then going to introduce ourselves to the patient. Something like, "Hello, my name's Keith. I'm a first aider, may I help you?" What we're doing by asking somebody is they may seem to be unconscious, but their hearing is often the last thing to go so it might be they can hear you even if they're in a sort of unconscious state, hearing of another voice can be quite soothing.

If you don't get an answer there, then give them a tap, just tap them on the collarbone. "Are you okay?" Ask them some direct questions. Again, we're trying to get a response through voice and also touch. If we haven't got any contact back or approval back at that stage, we would, in the eyes of the law, have their deemed consent to actually work on them because they're not answering then we can carry on. If someone was conscious and you asked them and they refused, then there's a problem. You can't help somebody unless they want to be helped but when they're in an unconscious state, it's not a problem.

Next thing we need to do is find out if the patient's breathing. It may be looking at them, you can quite easily see they've got colour in their cheeks, you can see the chest rise and fall, or maybe hear them breathing. But the proper breathing check is where you put one hand on the forehead, the underhand on the chin and you gently tilt the head back. One of the obstructions of the airway, or the most common obstruction, would be the tongue. The tongue can fall back and block the throat. By opening the airway, it will pull the tongue away from the back of the throat, allowing them to breathe. So approaching somebody who's not actually breathing but opening the airway can be all it takes to actually start them breathing again.

Once you've opened the airway, keep holding the chin and keep hold of the forehead, pop your ear down against their mouth and nose, and listen for up to 10 seconds for normal breathing. If there's something that doesn't sound like normal breathing or maybe just a gaspy type noise, then this could be what's called agonal breathing. This could be a sign of death, not of life so make sure you've got this patient, as an example this patient is breathing.

Now, if somebody's available, obviously you would shout for help at any stage. But if you're on your own, you don't really know what's happening yet and you can't leave the patient to call the emergency services because lying on their back, they may well vomit. If they vomit, they'll swallow that vomit and it'll get into their lungs and they can actually drown in the vomit. So what we need to do is lay them on their side. This is called the recovery position.

Now before we move them into the recovery position, have a look at what you think they're there for, what's caused it, or the mechanism of injury. This would be if someone has fallen you might suspect spinal injury but in this example, there's not likely to be anything there which has hurt them. But we could just do a quick head to toe check. So look at their head, around their body, you're looking for any fluids or blood, deformity, anything that's not quite normal. Also, look down their body. Are their legs roughly where they should be? Or could it be that there's a damaged hip? What we don't want to be doing is moving somebody and then causing even more injury.

In order to put them in the recovery position, they would normally be on their back to start with. If they're not on their back, it might be you can adjust this and just carry on with the technique we're about to show you, but just adapt it slightly. If somebody is on their back, just prop their legs together and then the hand that's nearest to you, prop it up into this position. Now that arm up out the way will be where the head eventually will end up resting. Take your other hand and bring it across, so that holding on to their thumb and bring the hand across so it's on the cheek that's nearest to you. Now keep hold of that thumb. With this hand, you can actually control their head to make sure the head doesn't move any violent actions.

With the other hand, put your arm across the body to the leg that's furthest away and bring it up so the foot is flat on the floor. What you can then do is use the knee as a lever to pull them towards you. So, with your hand on the knee, pull them towards you, supporting the head with the other hand and you're pulling them over in one action. Once they're over on their side, just tilt the head back to make sure the airway stays open. Just, you can pull your hand away and tuck their hand in. You can just adjust the position of the hand actually onto their face just so that they're nice and comfortable. With their leg, just lift it up so that's up in a bent position. The reason it's in the bent position is so they can't then roll back. This person's then laying down in a position where they can't roll over, they're going to be in a rested position.

If you've got somebody with a very sharp ring, you might need just to turn that in so they're then not laying onto the ring, somebody with glasses, may well just take the glasses off so that when you roll them, you're not going to damage their glasses.

With this person laying in the recovery position, we can then go and get help. So go and call the emergency services or call the centre managers and get help, come back to the patient. When you come back, you need to make sure you've checked that they're still breathing and they're still all okay. You can then get a blanket or something just to cover them over to keep them warm. Stay with them, monitor their breathing until the emergency services arrive.