The lateral position is a technique used in emergency first aid and medical care, designed to protect the airway of an unconscious person who is still breathing on their own. This simple maneuver involves carefully turning an individual onto their side, which drastically reduces the risks associated with a compromised airway. The position is a non-invasive method for maintaining respiration and waiting for professional medical assistance to arrive.
The Core Definition
The term “lateral position” refers to lying on one’s side, and in first aid, it is most commonly known as the Recovery Position. This is a specific, stable posture used when an individual is unresponsive but demonstrating normal breathing. The goal is to achieve a stable, semi-prone posture that prevents the individual from rolling onto their back or stomach.
The position is a modified three-quarters prone position, meaning the person is resting mostly on their side but stabilized by the limbs. While either side can be used, the left lateral recumbent position is sometimes recommended in certain clinical scenarios, such as for pregnant individuals, to relieve pressure on major blood vessels. In most general first aid situations, placing the person on whichever side is easiest and safest is acceptable.
Why the Lateral Position is Crucial for Airway Management
When a person loses consciousness, the muscles throughout their body relax completely, including the tongue. If the individual is lying flat on their back, this relaxation causes the tongue to fall backward against the pharynx, which can fully obstruct the airway. The lateral position uses gravity to pull the tongue forward and away from the back of the throat, thereby preventing this mechanical blockage and keeping the airway open.
The position also serves the function of preventing pulmonary aspiration, which is the inhalation of foreign materials, such as vomit or fluids, into the lungs. If an unconscious person vomits while lying on their back, fluids can easily pool at the back of the throat and be drawn into the trachea and lungs. By turning the person onto their side, the mouth becomes the lowest point of the head and neck, allowing any fluids to drain naturally out of the mouth.
This drainage capability is particularly important because aspiration of stomach contents can lead to severe lung damage, including aspiration pneumonia, which significantly worsens the person’s condition. The simple side-lying posture ensures that the airway is continuously protected from both physical obstruction by the tongue and contamination by fluids. Maintaining a clear airway through this position is a direct measure to prevent hypoxia, a dangerous condition where the body is deprived of an adequate oxygen supply.
Step-by-Step Instructions for Safe Placement
Before moving an unconscious person, ensure the surrounding area is safe and kneel beside them on the side toward which you plan to roll.
- Extend the arm closest to you straight out at a right angle to the body, elbow bent, with the palm facing upward. This extended arm acts as stabilizing support.
- Bring the person’s farthest arm across their chest, placing the back of their hand against the cheek closest to you to support the head during the turn.
- Lift the farthest leg, bending the knee so the foot rests flat on the ground. This bent knee acts as a lever to facilitate controlled movement.
- While keeping the hand pressed against the cheek, gently pull on the bent knee to roll the person toward you onto their side.
- Adjust the top leg so the hip and knee are bent at right angles to stabilize the position and prevent rolling.
- Tilt the head back slightly to ensure the airway remains open and adjust the hand under the cheek so the mouth is directed downward, enabling fluid drainage.
When to Avoid or Modify the Lateral Position
The lateral position should be avoided or significantly modified if a spinal, neck, or pelvic injury is suspected. Unnecessary movement in these situations could potentially cause further damage to the spinal cord. In cases of significant trauma, maintaining an open airway is the priority, but movement must be minimized.
For patients with suspected spinal injury, specialized techniques like the “log roll” are used, requiring multiple trained rescuers to turn the person as a unit while maintaining alignment of the head, neck, and torso. If alone, the rescuer should use the least amount of movement possible to open the airway, often employing a jaw-thrust maneuver instead of the head-tilt, chin-lift. The person should only be moved laterally if their airway is completely unmanageable in the flat position, and minimal, gentle movement is paramount until specialized help arrives.