Recovery position makes it harder to spot breathing difficulty

Putting patients in the recovery position after cardiac arrest may make it harder for doctors to spot signs of breathing difficulties, a small study has found

Putting patients in the recovery position after cardiac arrest may make it harder to detect breathing difficulties, a small study has found.

Spanish researchers recruited 59 students with an average age of 22 who had basic life-support training, and divided them into two groups.

The first received a refresher course in cardiopulmonary resuscitation, including the recovery position, and the other a modified cardiopulmonary resuscitation course using continuous head tilt and chin lift for unconscious and spontaneously breathing patients.

A simulation test to evaluate breathing assessment was performed a week later.

Head tilt technique

Only 14 of 27 in the recovery position group (52%) versus 23 of 28 in the head tilt group (82%) detected breathing arrest within two minutes.

Writing in the journal Resuscitation, lead author Maria del Pilar said: ‘Resuscitation guidelines endorse unconscious and normally breathing out-of-hospital victims to be placed in the recovery position to secure airway patency.

‘But recently a debate has been opened as to whether the recovery position threatens the cardiac arrest victim's safety assessment and delays the start of cardiopulmonary resuscitation.’

The team concluded the recovery position hindered breathing assessment and delayed identification of breathing arrest and the initiation of cardiac compressions.

It also significantly increased the likelihood of not starting cardiopulmonary resuscitation compared with when the continuous head tilt and chin lift technique was used.

del Pilar M et al (2017) Does lying in the recovery position increase the likelihood of not delivering cardiopulmonary resuscitation? Resuscitation. doi.org/10.1016/j.resuscitation.2017.03.008