Does the Recovery Position In First Aid Actually Work?

For many years, emergency care providers have been taught to put unconscious but breathing patients into the recovery position. This is done to prevent vomit and/or stomach contents from getting into the lungs. When this does happen it's known as aspiration.

In medical terms, the recovery position is called the lateral recumbent position. Sometimes it is also referred to as the lateral decubitus position. In nearly every case, first aid providers are advised to place the patient on their left side, called the left lateral recumbent position.

In the recovery position, the patient is positioned 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.

This article outlines when the recovery position should be used, how to properly position the patient, and when it should not be used.

woman putting man into recovery position
Gary Ombler / Getty Images

How to Put Someone in the Recovery Position

First make sure the scene is safe. If it is, the next step is to call 911 and then check to see if the patient is conscious or breathing. At this point, you should also look for other serious injuries such as neck injuries.

If the patient is breathing but not fully conscious and if no other injuries are present, you can place them in the recovery position while you wait for emergency personnel.

If an unconscious patient is not breathing, you must clear the airway before putting them into a recovery position.

To put a patient in the recovery position:

  1. Kneel beside them. Make sure they are face up and straighten their arms and legs.
  2. Take the arm closest to you and fold it over their chest.
  3. Take the arm farthest from you and extend it away from the body.
  4. Bend the leg closest to you at the knee.
  5. Support the patient's head and neck with one hand. Hold the bent knee, and roll the person away from you.
  6. Tilt the patient's head back to keep the airway clear and open.

Who Should Not Be Put in the Recovery Position

The recovery position is widely used in first aid situations, but there are some situations when it is not appropriate. In some cases, moving a patient on their side or moving them at all could make their injury worse.

Do not use the recovery position if the patient has a head, neck, or spinal cord injury.

For children under age 1: Place the baby face down across your forearm. Make sure to support the baby's head with your hand.

What the Recovery Position Is Supposed to Do

The goal of using the recovery position is to allow anything that is regurgitated to drain out of the mouth. The top of the esophagus (food pipe) is right next to the top of the trachea (windpipe). If matter comes up from the esophagus, it could easily find its way into the lungs. This could effectively drown the patient or cause what is known as aspiration pneumonia, which is an infection of the lungs caused by foreign material.

Historically, the left-side recovery position was preferred. Recent research, however, suggests that in most cases, it probably doesn't matter which side you put the person on.

Does It Work?

Unfortunately, there isn't much evidence that the recovery position works or doesn't work. This is because research so far has been limited.

What the Science Says

A 2016 study looked at the relationship between the recovery position and hospital admission in 553 children between the ages of 0 and 18 diagnosed with loss of consciousness. The study found that the children who were placed in the recovery position by caregivers were less likely to be admitted to the hospital.

Another study found that placing cardiac arrest patients in the recovery position could prevent bystanders from noticing if they stop breathing. This could lead to a delay in the administration of CPR.

Research has also found that patients with a form of heart disease called congestive heart failure (CHF) do not tolerate the left-side recovery position well.

Despite the limited evidence, the European Resuscitation Council still recommends placing unconscious patients in the recovery position, though it also notes that life signs should be continuously monitored.

How to Help Someone

The recovery position is useful in certain situations, sometimes with adjustments based on the circumstance.

Overdose

There’s more to an overdose than the risk of vomit aspiration. A patient who swallowed too many pills may still have undigested capsules in their stomach. Research suggests that the left-side recovery position may help decrease the absorption of certain drugs. This means someone who has overdosed may benefit from being placed in the left-side recovery position until help arrives.

Seizure

Wait until the seizure is over before placing the person in the recovery position. Call 911 if the person injured themselves during the seizure or if they are having trouble breathing afterward.

Also call 911 if this is the first time the person has had a seizure or if the seizure lasts longer than is normal for them. Seizures that last longer than five minutes or multiple seizures that happen in rapid succession are also reasons to seek emergency care.

After CPR

After someone gets CPR and is breathing, your main goals are to make sure the person is still breathing and that nothing is left in the airway if they vomit. That may mean putting them in the recovery position or on their stomach. Make sure to monitor breathing and that you are able to access the airway if you need to clear out objects or vomit.

Summary

The recovery position has been the standard position for unconscious patients for many years. There isn't much evidence that it works or doesn't work. A few studies have found benefits, but others have found that the recovery position may delay the administration of CPR or harm patients with congestive heart failure. 

How you position a person depends on the situation. The recovery position may help keep a person from absorbing a substance they've overdosed on. It can also be helpful for someone who has just had a seizure. Most importantly, an unconscious person needs emergency care, so make sure you call 911 prior to putting them in the recovery position.

A Word From Verywell

The practice of putting unconscious patients in the recovery position hasn't changed in decades. That might be because aspiration isn't really all that common in most patients. In fact, aspiration is mostly a problem with older dementia patients who have a hard time swallowing.

The recovery position is taught in a very precise way, but the real world isn't precise. Understanding what you need to accomplish is more important than how you do it. The goal is to keep the person from aspirating something into their lungs. That may mean putting them in the recovery position or on their stomach. Most importantly, make sure to watch their breathing and if they stop, roll them back over and start CPR.

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8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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