How Do You Put Someone in the Recovery Position?

Somebody is unconscious and breathing. They've fainted, or had a seizure, or drunk far too much, or taken something. They're alive and they aren't responding to you, and the question in your head is whether you should move them or leave them exactly as they are.

Move them — onto their side. Here's the check to do first, and the reason it matters more than the technique.

Breathing normally, or not at all

This is the only part of the page that can hurt somebody if you get it wrong, which is why it comes before the technique. Watch the chest for up to ten seconds. Regular, quiet, repeated movement is normal breathing. Anything slow, noisy or occasional isn't — and that distinction has its own short lesson because it catches almost everyone.

Breathing normally and unresponsive: this page. Not breathing normally: start CPR.

What lying on a side actually achieves

Two things, and knowing them means you can get this right without memorizing a diagram.

An unconscious person lying on their back has a relaxed tongue that can fall against the back of the throat and block the airway. And if they vomit — which is common after alcohol, drugs or a head injury — it has nowhere to go but back down.

Turning them onto their side fixes both at once. Gravity keeps the tongue forward, and anything that comes up runs out of the mouth rather than into the lungs. That's the whole idea, and every detail below is in service of it.

Rolling someone onto their side: step-by-step

1. Kneel beside them and straighten their legs. Check pockets for anything hard or sharp.

2. Take the arm nearest you and place it out at a right angle, elbow bent, palm facing up.

3. Bring the far arm across and hold the back of their hand against their near cheek.

4. Pull the far knee up so the foot stays flat on the floor.

5. Roll them toward you by pulling on that raised knee, keeping their hand against their cheek so the head comes with the body.

6. Adjust the head so it's tilted slightly back and the mouth points a little downward.

7. Settle the top leg with hip and knee bent at right angles, so they can't roll onto their front.

If your roll didn't go exactly like the steps above, check it against those five things instead. Different organizations teach slightly different versions of this and they all satisfy the same five properties — the properties are the standard, not the choreography.

Possible spinal injury, and the honest answer

This is the question that stops people, and it deserves a straight answer rather than a reassurance.

If somebody fell from a height, came off a bike, or was in a crash, a spinal injury is genuinely possible and moving them carries a genuine risk. It is also true that an unconscious person choking on their own tongue or vomit is an immediate and certain problem, where the spinal risk is a possible one. An open airway wins that comparison.

So: call 911 first and say what happened, because the answer may be that help is two minutes away and you should support the head where they are. If you do need to move them, keep the head, neck and spine in line and roll the whole body together — which is easier with a second person, one at the head and one at the body.

What you don't do is leave somebody face-up and gurgling because you're frightened of moving them. That fear is reasonable and it is pointing at the smaller of two risks.

Staying and watching

The position isn't a place to leave someone. It's a way of keeping their airway open while you wait, and the waiting is the job.

• Call 911 if you haven't, and say they're unconscious but breathing.

• Watch the chest — properly, not occasionally. Breathing can stop.

• If breathing stops or turns to gasping, roll them onto their back and start CPR immediately.

• Keep them warm and keep talking to them, even with no response.

• Swap the side after about 30 minutes if help is still coming, so the lower arm isn't bearing weight indefinitely.

Pregnancy and babies

Two variations worth knowing. Someone visibly pregnant goes onto their left side, which keeps the weight of the uterus off a major vein and helps blood return to the heart.

A baby under a year isn't rolled at all — hold them in your arms, face angled downward, with the head supported and slightly lower than the body. And if a baby stops breathing normally, infant CPR is the answer rather than any position.

Put it into practice

Training scenario:

It's about one in the morning at a friend's house. Someone at the party has had far too much to drink, has been asleep on the sofa for an hour, and has now slid down so they're lying on their back with their head against the armrest. They don't wake up when you say their name or shake their shoulder. They're breathing — you can see their chest moving steadily. Two people have said to just let them sleep it off.

Walking it through:

First the check, and it passes: unresponsive, breathing steadily. That means this is the recovery position rather than CPR. If the breathing had been irregular or noisy, this would be a very different night.

So roll them onto their side, get the mouth angled slightly downward, and settle the top leg so they stay put. It takes about twenty seconds. What the sleep-it-off advice gets wrong is the vomiting — someone that drunk is likely to be sick, and on their back with a depressed gag reflex, that is exactly how people die at parties. On their side it runs out of their mouth.

And then the part nobody wants to hear at one in the morning: somebody stays with them, and it should be you if nobody else volunteers. Unresponsive to a shout isn't the same as asleep. If you can't rouse them at all, that's worth a 911 call rather than a shrug — and if their breathing changes while you're sitting there, you already know what that means.