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Now we are going to have a look at three different methods of putting a patient in the recovery position. For ease of filming, Mike is lying flat on his back, but unfortunately, most casualties will not be lying flat on their back and will have to be put in onto their back to make this work effectively and properly. And do not be afraid to move patients. Firstly, we look at the traditional method, the method that most people get taught every day in their first aid at work courses and it is the how position. We take one hand, open to the how position, we bring the second hand across to the side of the face, making sure no rings or anything are damaging the face and we hold it in that position. A lot of people let go at this point, but unfortunately, if you do, the hand will just fall completely flat back, so keep control of the hand at all times.

We then raise the knee on the opposite side and use the knee as a lever point, pressing down on the knee and controlling the face, rolls the patient towards me. Always roll the patient toward you. If you push away, they tend to roll straight over onto their face and we have got to repeat the system to get them back over again. So press down on the knee and bring the patient towards you in one smooth motion. When they are across, bring the knee to stop them rolling back over, and the head allows the airway to drain, it allows the tongue to fall forward, removing any blockages from the back of the throat and the really critical part about the recovery position and the piece that most people forget, is we must monitor breathing. It is incredibly common to arrive on scenes at cardiac arrests and find the patient beautifully in recovery position because people do not monitor breathing and the patient arrests whilst in this position and nobody notices that it has happened.

It is difficult to see the breathing when they are in a recovery position. So please remember, keep an eye on the breathing, keep the airway clear. The second recovery position we are going to have a look at is a position used by the ambulance services in case somebody has the likelihood of a back or neck injury, it takes a little bit more care of the back and tries to keep the back as straight as possible in the move itself. So, we start the process in the same method, one hand into the how position, we then bring the arm into the same position, checking for rings, so that we do not damage the face, holding the hand there with one hand, we then raise the knee. So, so far it is exactly the same as the original recovery position, but then we put an elbow to knee and hand to hip and we put elbow to elbow to shoulder and then what we do is we press down with the elbows and roll the patient square, and this time you will see the back comes in a completely flat square position.

Reducing any twists to the spine and neck, we would bring the knee round into the same position again and the patient has been rolled so as we can check the back, we can keep the airway clear but we have not twisted the spine. The third recovery position was designed for the use of stretchers or in confined spaces where we do not have a lot of room and also when we have to act fast because of the worry of an airway blockage. What you have to remember is in the lying position or on flat on their back if they vomit or regurgitate anything, we need to drain as quickly as possible, we only get a few seconds of warning that that is going to happen, so if we have to follow all the how positions that take too long, this method is a fast, slick way of recovery position or clearing an airway whilst on a narrow or on a stretcher in the back of an ambulance. We take one hand, we check the arm is okay, there is no breaks, no fractures, no cuts or bruises and we place the hand underneath the back of the head.

Our patient is now prepped ready. If this patient now vomits, starts to retch or we need to put them into the recovery position quickly, all we need to do is to bring the arm and wrist across the chest, hold the knee, trousers at the knee and literally roll and the patient rolls straight into the recovery position, again, keeping the spine straight, but it is a position that could be used very quickly where they protect their own head. The head does not hit the floor, the neck and spine keep straight and to reverse, to take the patient back on to the stretcher, all we need to do is lift the knee and the patient rolls back onto the stretcher so as we can carry on our examinations. It is a very quick technique for dropping somebody into a recovery position without all the time taken to put the hands in separate positions. We are prepped and ready to go with just a quick pull.

This technique is also very useful for teaching children how to move adults into the recovery position very quickly, because when they have to stretch and use one arm as we would do in the conventional system, they sometimes are not strong enough to do it and with this method, all you need to do is to raise one leg, put the pressure on one leg and the patient rolls directly into the recovery position, protecting their head from hitting the floor with their arm and again keeping their back straight, but the lever point is more effective with the hand under the back of the head.

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