When to put someone into the Recovery Position
The person should not be routinely rolled onto the side to assess airway and breathing
leave them in the position in which they have been found. This has the advantages of simplified teaching, taking less time to perform and avoids movement.
The exceptions to this would be where the airway is obstructed with fluid (water or blood) or matter (sand, debris, vomit). Here, the person should be promptly rolled onto their side to clear the airway.
The mouth should be opened and the head turned slightly downwards to allow any obvious foreign material (e.g. food, vomit, blood and secretions) to drain. Loose dentures should be removed, but well-fitting ones can be left in place.
Visible material can be removed by using the rescuer’s fingers. Case series reported the finger sweep as effective for relieving foreign body airway obstruction (FBAO) in unconscious adults and children aged >1yr
However, five case reports documented harm to the person’s mouth or biting of the rescuer’s finger1 [Class B; LOE IV, extrapolated evidence]. If the airway becomes compromised during resuscitation, promptly roll the person onto their side to clear the airway. Once the airway is clear, reassess for responsiveness and normal breathing, then begin resuscitation as appropriate following the ANZCOR Basic Life Support Flowchart (Guideline 8).
Regurgitation is the passive flow of stomach contents into the mouth and nose. Although this can occur in any person, regurgitation and inhalation of stomach contents is a major threat to an unconscious person. It is often unrecognized because it is silent and there is no obvious muscle activity.
Vomiting is an active process during which muscular action causes the stomach to eject its contents. In resuscitation, regurgitation and vomiting are managed in the same way: by prompt positioning the person on their side and manual clearance of the airway prior to continuing rescue breathing.
If the person begins to breathe normally, they can be left on their side with appropriate head tilt. If not breathing normally, the person must be rolled on their back and resuscitation commenced.