Recovery Position

The recovery position or semi-prone position is a technique recommended for assisting people who are unconscious or semi-conscious and are able to breath on their own. It is also known as semi-supine laying position.

Two main risk factors are present when an unconscious or semi-conscious person is lying facing upwards. It can lead to suffocation of the person.

• The person's tongue can fall backwards and obstructs the airway due to loss of muscular control.
• Fluids like blood, vomit or saliva can collect at the back of the person's throat thereby creating the possibility of drowning the person.

When a person is lying face up, the esophagus (gullet) tilts down slightly from the stomach towards the throat. This, combined with loss of muscular control, can lead to the stomach contents flowing into the throat. This is known as passive regurgitation.

As well as obstructing the airway, fluid which collects in the back of the throat can also flow down into the lungs via the trachea (windpipe). Stomach acid will then be able to attack the inner lining of the lungs and cause a condition known as aspiration pneumonia (AP).

***AP develops due to the entrance of foreign material (including food, saliva or nasal secretions) that enters the bronchii. Depending on the acidity of the foreign material, a chemical reaction can occur and presence of bacteria may add to the inflammation***

The main purpose of teaching recovery position in lifesaving is such that the victim can lie down comfortably and breath on their own while the rescuer can maintain a watchful eye for any changes that is shown by the victim.

A good recovery position in my opinion comprises of:

• Ensure victim's airway is open at all times (head-tilt-chin-lift position)
• Ensure victim's mouth is downwards (facilitate in draining of blood and saliva)
• Ensure chest and stomach does not lay flat on the ground surface (easier to breath)
  
• Ensure victim's arm and knee are locked to maintain stability
  
• Rescuer is able to maintain visual contact of the victim while checking for signs of circulation every 5 min

In the recovery position, the law of gravity will keep the tongue from obstructing the airway as well as enables the draining of fluid from the mouth such that the victim will not choke on their own vomit or saliva.

For pregnant victims, they should always rest on her left side as lying on her right side may cause the uterus to compress the Inferior Vena Cava thereby making death a possibility!

For victims with torso wounds, it is recommended to place the wounds closest to the ground to minimize the possibility of blood going into the lungs causing a condition known as asphyxiation.

***Asphyxia is a condition of severely deficient supply of oxygen to the body***

DR ABC

The information below including figures are extracted from Wikipedia. The free online encyclopedia. =)

DR ABC

A simple mnemonic is used to aid the memory of the clinical approach to the unconscious victim and CPR. DR ABC, which stands for Danger, Response, Airway, Breathing and Circulation. Complex mnemonic can reach up to complicated levels such as DR AcBCDEEEFG! I will explore this in a later stage.

Early CPR is essential to the prevention of brain damage during cardiac arrest and increases the chance of survival. It maintains blood flow and perfusion to the brain, buying time until AED and/or professional help (paramedics) arrives. On average, about 5% - 10% of people who receives CPR survive.

ABC is designed to remind first aiders and lifesavers of the correct procedure (including the order) in which to deal with a non-breathing victim.

A --- Airway

If the victim's airway is blocked, oxygen cannot reach the lungs and so cannot be transported around the body via the blood. Ensuring a clear airway is the first step. The common causes of airway blockage are tongue and vomit.

In order to open the airway, a method called head-tilt-chin-lift technique is applied. This way, the tongue will be lifted upwards thereby opening up the airway.

B --- Breathing

Next, the victim will be assessed for breathing. Common findings during assessment of breathing may include normal breathing, noisy breathing, gasping or coughing. The next step is based on these. If all seems well, the victim will be placed into the Recovery Position. If absence of breathing is determined, the lifesaver will commence to give 2 rescue breaths. Administering Rescue Breathing is a possibility here.

C --- Circulation

Once oxygen can be delivered to the lungs by a clear airway and efficient breathing, there needs to be a circulation to deliver it to the rest of the body. This can be assessed by doing a pulse check on the carotid artery (neck).

In short, if a victim is determined by absence of pulse and breathing, CPR will be administered. If a victim is not breathing but pulse is present, Rescue Breathing will be administered.

DR ABC

The most commonly taught mnemonic is DR ABC where the D and R stand for Danger and Response. This is to protect yourself before attempting to help others and also to ascertain that the victim is unresponsive before attempting to aid them.

ABCD

• D stands for Defibrillation. --This is quite an essential part of CPR. The arrival of AED. A machine which is able to aid in defibrillating the heart thus making the survival rate from cardiac arrest higher.

ABCDEEE

The 3 Es here can stand for:

• Environment -- only after assessing ABCD does the lifesaver deal with environmentally-related symptoms or conditions such as cold and lightning.
• Escaping Air -- Checking for air escaping such as through a sucking chest wound, which could lead to a collapsed lung.
• Expose and Examine -- This is predominantly for paramedics where it is important to remove clothing and other obstructions in order to assess wounds.

ABCDEEEF

The F can stand for:

• Fundus -- relating to pregnancy, a reminder for paramedics to check if a female is pregnant and how far progressed she is.
• Family -- the paramedics have to deal with the witnesses and the family as they can give precious information about the accident or the health of the victim.

ABCDEEEFG

The G stands for:

• Go Quickly! -- A reminder to ensure all assessments and on-scene treatments are completed with speed, in order to get the victim to the hospital as soon as possible.

AcBCDEEEFG

• The small 'c' stands for cervical spine. -- This is a reminder to be aware of potential neck injuries to a victim, as opening the airway may cause further damage (tilting of the head). If suspected neck injuries, a cervical collar has to be put on to the victim's neck and using Jaw Thrust to open the airway.

When can you stop administering CPR?

There are 5 ways whereby a lifesaver can stop giving CPR.

• Effective, spontaneous circulation and ventilation are restored.
• Resuscitation is transferred to another trained person.
• Paramedics arrive to take over.
• You are too exhausted and tired to continue
• Continued resuscitation will place lives of others at risk.