The Unconscious Casualty

When breathing has been restored, it is essential to maintain the airway and ensure the tongue, fluids or other objects do not cause an obstruction. It is also important to reduce the risk of inhalation of stomach contents.

Any unconscious casualty who remains on their back risks an obstructed airway by solids, fluid or by having their upper airway blocked by a relaxed tongue.

The most effective way of controlling this problem is to put the unconscious breathing casualty in a position that ensures the airway remains open by draining away any vomit or by allowing the relaxed tongue to move away from the airway opening. This position is called the recovery position.

This position places the casualty on their side, with the head down and tilted in such a way any fluid is expelled onto the ground and the tongue falls clear of the airway opening.

Place women in advanced pregnancy on the left side to prevent distress to the foetus, unless prevented by injuries.

Procedures for placing a casualty in the recovery position

• Prepare the casualty by checking pockets and removing items such as keys and spectacles
• Kneel beside the casualty and make sure both their legs are straight
• Place the arm nearest to you out at right angles (90°) to the body
• Bring the arm farthest from you across the chest and place the back of the hand under the casualty’s cheek
• Using your other hand, grasp the farthest leg just above the knee and pull it up, ensuring the foot stays on the ground
• Keeping the hand under the casualty’s cheek, pull the leg towards you to roll the casualty onto their side
• Adjust the upper leg so both the hip and knee are bent at right angles
• Tilt the head back to make sure the airway remains open
• Adjust the hand under the cheek to keep the head tilted
• Check the casualty’s breathing regularly

If the casualty is to remain in the recovery position for any more than 30 minutes, turn them over to the other side if injuries permit.