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First Aid at Sea revision module 3 of 8

REC

Recovery Position in Confined Space

A teaching-first recovery-position decision sequence covering normal versus abnormal breathing, the trauma exclusion, ordinary cramped-cabin adaptations, hazardous enclosed-space boundaries, continuous monitoring and responder handover.

8 guided lessons · 8 practice questions · 8 flashcards

Lesson previewWhy Recovery Position Matters1 section shown

Preview lesson

Why Recovery Position Matters

What you will learn

Decide when the lateral recovery position is an appropriate airway-protection path and when abnormal breathing, trauma or scene danger requires a different response.

Recovery position is for a person with decreased responsiveness who does not meet the criteria for CPR; current guidance excludes agonal breathing and trauma from that path.

The decision begins with scene safety, response and breathing, not with a memorised body position. Resuscitation Council UK recommends a lateral recovery position for an adult or child with decreased responsiveness who does not meet the criteria for CPR. If breathing is abnormal, doubtful or agonal, that is the cardiac-arrest recognition path rather than evidence that the person is safe to position and watch.

Trauma is a separate exclusion in the 2025 guidance: do not move a person with trauma into the recovery position. Minimise neck movement, do not force a position and use current practical training and emergency-operator support for airway and immediate-safety decisions. A favourable-looking side position must never replace the breathing and injury gate.

Afloat, call early and keep vessel safety owned while the assessment continues. The recovery position can support airway protection and drainage, but it is not treatment for the underlying event, proof of normal breathing or permission to leave the casualty. This online lesson rehearses decisions only; it cannot teach or verify the physical manoeuvre.

Recovery-position decision board

Rehearse the gate before thinking about the position

Select an observed situation to compare safety, the breathing and trauma gates, the position boundary, monitoring and handover. Every state is written in text and does not depend on colour.

  1. 1Protect
  2. 2Call + boat
  3. 3Breathing gate
  4. 4Position boundary
  5. 5Monitor
  6. 6Handover

The gates do not average out: clearly normal breathing cannot cancel trauma, and an urgent casualty cannot make a suspected hazardous space safe for untrained entry.

1 · Protect

Confirm the scene and treatment space remain safe for the casualty and rescuer. Keep vessel movement, cold, loose gear and access under control.

2 · Call + boat

Start the effective emergency contact for the position and give the observed unresponsiveness. Keep helm, lookout and the rescue route owned.

3 · Breathing gate

Breathing is clearly normal, the person has decreased responsiveness and they do not meet the criteria for CPR. Continue to reassess rather than declaring recovery.

4 · Position boundary

With no trauma, use the lateral recovery-position method from current recognised practical training. This board cannot select or teach the physical manoeuvre.

5 · Monitor

Keep the face and breathing movement continuously visible. Report abnormal, doubtful or changed breathing immediately and change response path as directed.

6 · Handover

Give response, exact breathing description, absence of a known trauma mechanism, position, timed changes, actual care, access and every uncertainty.

Decision rehearsal only. This board cannot assess a casualty, diagnose, teach or verify physical recovery-position movement, airway opening, CPR, casualty extraction, confined-space entry or rescue, provide medical advice, or direct a real emergency. Use current recognised practical training, contact HM Coastguard or the applicable emergency service immediately, and follow trained professional instructions.

Choose an observed situation and rehearse the safety, breathing, position, monitoring and handover decisions without simulating casualty movement.

Worked example

A crew member becomes unresponsive in a dry cockpit after feeling unwell. Another crew member has the helm. Breathing appears regular and clearly normal, and there is no fall, impact or other trauma mechanism.

  1. 1The first aider states the observed response and breathing; another crew member starts the effective emergency contact and keeps the vessel controlled.
  2. 2Because CPR criteria and trauma are not present, the first aider uses the lateral recovery-position method from current practical training without inventing a diagnosis.
  3. 3The crew keeps response and breathing continuously visible, protects against cold and movement, and reports any change immediately.

Sense check: The decision depends on current breathing and trauma evidence, not simply on the word unresponsive or on fitting the casualty into a familiar pose.

Why Recovery Position Matters
Decreased responsiveness; breathing clearly normal; no traumaUse the lateral recovery-position path from current training and keep monitoringNormal breathing proves recovery
Abnormal, doubtful or agonal breathingTreat as the CPR recognition path and follow the operatorAny breath means recovery position
Trauma suspectedDo not move into recovery position; minimise movement and obtain urgent guidanceAirway concern automatically authorises a routine roll
Scene or vessel hazardControl danger and call while trained care continuesA tidy position matters more than rescuer or vessel safety

Say the gate before the position

A second crew member asks whether to put the casualty into the recovery position.

  1. 1. State what is observed

    Describe responsiveness, whether breathing is clearly normal, and whether trauma or scene danger is suspected.

  2. 2. Name the path

    Say recovery-position path, CPR path, trauma path or hazardous-space stop boundary rather than saying only yes or no.

  3. 3. Keep the system active

    Confirm who is calling, controlling the boat, observing breathing and preparing access for help.

Sense check: A useful answer explains why the path fits the observed state and which change would make it wrong.

Common mistake or limitation

  • Treating all visible breathing as normal; gasping, panting, slow or laboured breathing may be abnormal.
  • Using the recovery position for trauma even though current guidance says not to move a trauma casualty into it.
  • Treating side-lying as evidence that the airway, breathing, vessel and emergency response no longer need attention.

Recap

  • Recovery position follows a normal-breathing, no-CPR, no-trauma decision gate.
  • Abnormal or doubtful breathing and trauma each take a different response path.
  • The lesson rehearses judgement; practical positioning requires current hands-on training.

Optional quick check

Section 1 of 1

An unresponsive crew member is gasping irregularly after collapsing. Which path fits the evidence?

Choose one answer