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What is the recovery position and is it always ‘safe’?

“I heard about a girl who passed out after drinking and her friends put her in the recovery position in a field and left her to sleep it off.  When they went back the next morning she was still unconscious, so they called an ambulance.  She ended up having her lower leg amputated, because of being left on her side. Is the recovery position always safe? “

If a person is unconscious but is still breathing, they should be placed in the recovery position. Putting someone in the recovery position keeps their airway open so they can continue to breathe and also helps to ensure that if they vomit they won’t choke.

When you are unresponsive or unconscious, your muscles relax. The tongue is a big muscle that’s attached to your jaw, so if you’re unconscious and lying on your back, it can move back and block your airway. Unconscious people also lose their gag reflex, which is the ability to vomit or cough to clear their airway. In addition, the muscle at the top of your stomach (known as a sphincter) relaxes, allowing whatever is in your stomach (e.g., vomit, acid) to move up into your airway and drain into your lungs. This is extremely dangerous. When you hear the expression, ‘choked on their vomit’, this is what they’re referring to. It’s for these reasons that we put unconscious people on their side whilst waiting for medical help.

To ensure the unconscious person stays on their side and doesn’t roll onto their face, their arm is placed out and their top knee bent over. This keeps them in the safest position whilst waiting for an ambulance. Done correctly, the recovery position shouldn’t cause any harm to the patient.

So, what might have gone wrong with the story above?  It’s difficult to know for sure but here are some things that may have resulted in this tragic outcome:

The patient was placed in the recovery position incorrectly. When a person is unconscious, they’re unable to readjust their body position if they become uncomfortable. If someone was lying on their side with their top leg leaning on the bottom one, it could cut off the circulation. If this position remained for a length of time, it could lead to cell death and amputation.

The patient was left in the recovery position for too long. The recovery position is the safest position for a patient whilst waiting for medical aid, but it should only be short-term. Being unconscious is a medical emergency and always requires a medical opinion to ensure the patient recovers.

The patient was left in a cold environment. People who are alcohol affected can get very cold, very quickly (hypothermia). Leaving a drunk person outside for too long can result in a range of significant health problems.

This story highlights some important notes on the recovery position including:

  • being unconscious is a medical emergency and always requires an ambulance
  • the recovery position is the safest short-term position for a person waiting for medical assistance, not for long-term management
  • knowing how to do it correctly is important to keep the person safe
  • drunk people get cold very quickly, so keep them warm whilst you are waiting for help
  • never, ever leave someone who is drunk or non-responsive alone, always stay with them and get help
  • knowing how and when to do the recovery position can save a life.  Make sure you know what to do if something goes wrong

First published: April 2019
Reviewed and updated: September 2023

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