Recovery position is a series of variations on three-quarters prone or lateral recumbent position of the body, to which breathing, but unconscious, person can be placed as a part of the recovery process.
According to doctors, an unconscious person who scores 8 or below on a Glasgow Coma Scalemight not have an open airway in the supine position as compared to a conscious person.
This might result in obstruction of the airway which restricts proper airflow that, in turn, prevents the exchange of undesired gases which can result in a life-threatening condition called hypoxia (lack of adequate oxygen supply).
Globally, thousands of fatalities occur annually where unconsciousness is not fatal, but airway obstruction results in the patient to suffocate.
This holds true for unconscious pregnant women, who, when turned on their left, have an unrestricted venous return, thanks to pressure relieved on their inferior vena cava. Unconsciousness can be caused by any reason ranging from alcohol intoxication to trauma.
The recovery position is not generally used by emergency medical technicians or other healthcare professionals, as they have access to much-advanced techniques like tracheal intubation.
While European medical professionals practiced several recovery positions, the recovery position technique was popularized in the US only in the early 1990s when the American Heart Association adopted it in 1992.
International Liaison Committee on Resuscitation (ILCOR), in 1996, made recommendations on the fundamental principles concerning recovery positions but has not prescribed any specific position, which has resulted in different countries using different positions.
Purpose Of Recovery PositionRecovery position has been designed to ensure that the casualty does not suffocate due to airway obstruction that can occur in unconscious patients who are lying supine. A patient in a supine position has two types of airway obstruction:
Mechanical obstruction:The casualty’s airway is obstructed by the presence of a physical object, the patient’s tongue in most cases. Unconsciousness leads to loss of muscular control and tone resulting in the tongue to collapse into the pharynx, causing an obstruction.
Fluid obstruction:Fluids, like vomit, tend to get collected in the pharynx, which causes the person to drown.
Collapsing tongue causes blockage in the throat resulting in the stomach contents to flow into the throat; a process called passive regurgitation. The collected fluid can also cause lungs drown.
The stomach acid can even burn the lung's inner lining, causing the person to have aspiration pneumonia.
ILCOR GuidelinesPlacing an unconsciousness patient into a recovery position helps in the clearance of the throat with the help of gravity.
There is no specific position recommended by ILCOR, but it advises the following six fundamental principles:
- The casualty/patient should be in near true lateral position as allowable. The head should be angled downwards in a way that allows free fluid drainage.
- The position has to be stable.
- Avoidance of any pressure on the chest that might impair breathing.
- The patient should be turned on to the side and then back on the original position as slowly as possible. This step should not be done if the patient has any spinal injuries.
- One should be able to observe and have good access to the airway.
- The position should not result in any injury to the patient.