Initial Assessment and the Recovery Position

In this film, we will look at the initial assessment of a casualty and how to place someone into the recovery position safely and correctly.

Calling for Help

If someone is with you and the situation requires it, ask them to call the emergency services immediately. If you are alone, continue with your assessment first and then call for help as soon as it is safe to do so.

You may also be able to shout for help to attract the attention of others nearby.

Check for Response

Approach the casualty and introduce yourself:

“Hello, my name’s Keith. I’m a first aider.”

Gently tap the casualty on the collarbone and ask permission to help.

• If they are conscious, talk to them, find out what has happened, and encourage them to remain still while you assess them.
• If they are unconscious, you must immediately check whether they are breathing.

Check for Breathing

To check breathing, you must first open the airway.

• Place one hand on the forehead and the other under the chin
• Gently tilt the head back and lift the chin to move the tongue away from the back of the throat
• Quickly look into the mouth for any visible obstruction

With the airway open, look, listen, and feel for normal breathing for up to 10 seconds:

• Look for the chest rising and falling
• Listen for breathing sounds
• Feel for air on your cheek

If the casualty is not breathing, you must call the emergency medical services immediately and begin CPR.

If they are breathing normally, CPR is not required.

When the Casualty Is Breathing Normally

If the casualty is breathing:

• Send someone to call an ambulance, ensuring they return and tell you when help is on the way
• Your priority becomes maintaining an open airway and preventing choking

Head-to-Toe Check

If gloves are available, put them on and carry out a quick head-to-toe assessment before moving the casualty.

• Gently feel the shoulders, arms, and chest for deformity, bleeding, or fluid
• Check the hips and legs are in a normal position

If you find no signs of significant injury, the casualty can be placed into the recovery position.

Placing the Casualty into the Recovery Position

1. Ensure the casualty is lying on their back with their legs straight and together
2. Place the arm nearest to you out at a right angle to the body
3. Take the far arm and bring it across the chest, holding the hand against the cheek nearest to you
4. With your other hand, bend the far knee so the foot is flat on the floor
5. Using the leg as a lever and supporting the head and airway, gently roll the casualty onto their side, facing you

Once in position:

• Check that the airway is open
• Ensure the casualty is breathing normally
• Adjust the legs to help maintain stability

Ongoing Care

From this point, your role as a first aider is to:

• Keep the casualty comfortable and warm
• Speak to them reassuringly, even if they are unconscious
• Monitor their breathing continuously

If you are alone and need to leave to get help:

• Check that they are breathing before you leave
• Check again immediately when you return

Important Guidance on Injuries

Current guidance from the UK Resuscitation Council and the European Resuscitation Council (ERC) states:

• The recovery position is ideal for an unconscious casualty who is not injured
• If the casualty is injured, it is usually best to leave them on their back to avoid worsening injuries
• If the airway is compromised or fluid is present in the mouth, the recovery position may still be required
• If you must leave an injured casualty to get help, place them in the recovery position to protect the airway

Key Points to Remember

• Introduce yourself and check for response
• Open the airway and check for breathing early
• Start CPR if they are not breathing
• Use the recovery position to protect the airway when breathing is present
• Monitor the casualty until emergency help arrives

Calm, structured actions save lives.