The “restorative”, or stable lateral, position is used in unconscious victims with spontaneous breathing in order to prevent retraction of the tongue and the occurrence of asphyxia. There are several modifications of the "restorative position", none of them is preferable. The position should be stable, close to natural lateral, without chest compression.
Sequencing
1) remove glasses from the victim and straighten his legs;
2) sit on the side of the victim, bend his arm, which is closer to you, at a right angle to the body;
3) take the palm of the second hand of the victim in your palm and put his hand under his head;
4) with your other hand, grab the knee of the victim farthest from you and, without lifting your legs from the surface, bend as much as possible at the knee joint;
5) using the knee as a lever, turn the victim on his side;
6) check the stability of the position of the victim and the presence of breathing.
Obstruction (blockage) of the upper respiratory tract by a foreign body is most often associated with food intake.
With partial blockage of the upper respiratory tract, there is a cough, sharply shortness of breath, noisy breathing, cyanosis (blue) of the skin, while the victim often wraps himself around his neck (“universal symptom of respiratory stress”). The victim, as a rule, is able to independently achieve coughing up a foreign body.
With complete blockage upper respiratory tract (asphyxia) breaths and coughing shocks of the victim are ineffective, there is a rapid loss of voice and consciousness. The victim needs immediate help.
First aid
If the casualty is breathing on his own, observe the efficiency of his breathing and encourage him to cough. If the victim is conscious, but his weakness progresses, breathing and coughing weaken and stop, apply a series of 5 shocks between the shoulder blades:
- stand to the side and slightly behind the victim;
- grab the victim under the upper shoulder girdle with one hand and tilt him forward;
- with the edge of the second palm, apply 5 pushes between the victim's shoulder blades.
Don't try to land all 5 thrusts at once! Control the removal of the foreign body from the victim's mouth after each push!
If the application of pushes between the shoulder blades was not effective, perform the "Heimlich maneuver" - the application of abdominal pushes:
- stand behind the victim and wrap your arms around the body under the upper shoulder girdle at the level of the upper abdomen;
- supporting the torso, tilt the victim forward;
- fold one of your hands into a fist and place it with your thumb towards the body along the midline of the body in the middle of the distance between the navel and the xiphoid process of the sternum (costal angle), with your other hand fix the fist on top;
- apply a series of 5 sharp intense shocks in the direction from the bottom - up and from the outside - inward to the diaphragm, achieving the removal of the foreign body.
If abdominal thrusts were ineffective for the victim in consciousness, combine the application of 5 shocks between the shoulder blades.
If the victim has lost consciousness, it is necessary to start basic life support measures according to the rules described above (paragraphs 4-7):
- gently lay the victim on a flat surface;
- immediately organize an ambulance call (03,112);
- in the absence of spontaneous breathing in the victim, immediately begin chest compressions in a ratio with artificial breaths (30:2);
- before artificial breaths, check the victim's oral cavity and remove possible foreign bodies under visual control.
Obstruction of the upper respiratory tract by a foreign body in an obese victim or a pregnant woman
Technique of jerky pressure on the chest in a standing or sitting position:
- stand behind the victim, place your foot between his feet, grab his chest at the level of the armpits; place the hand of one hand, clenched into a fist, with your thumb in the middle of the sternum, clasp it with the brush of the second hand; perform jerky movements along the sternum towards yourself until the foreign body comes out;
- if the casualty is unconscious, begin basic resuscitation immediately.
The drawings show the technique of pushing the sternum in the supine position for obese victims and pregnant women.
Stable lateral position (SBP) is a position in which an unconscious but breathing person is placed while waiting for an ambulance to arrive.
Why is a stable lateral position performed?
With loss of consciousness, all the muscles of a person relax. Lying on his back in this state, a person may suffocate due to the retraction of the tongue into the throat or choke on vomit. A stable lateral position prevents tongue retraction, allows breathing and helps to eliminate saliva and vomit.
When to Use the Steady Side Position
- With or loss of consciousness.
- During a coma unknown origin.
- In case of poisoning drugs.
- Able alcoholic coma.
- During stroke or heart attack.
Algorithm for performing a stable lateral position
Preparing for the turn
- If the patient wears glasses, remove them.
- Make sure the patient's legs are straight, lying together and in line with the body.
- Get on your knees next to the victim.
- Place the arm closest to you at a right angle to your body and bend it at the elbow near your head, palm up.
- Take your other hand, move it to your side and put it to your ear with the back of your hand. Hold it in this position - this will help reduce the movement of the cervical vertebrae during the rotation of the victim, which will reduce the risk of aggravating a possible neck injury.
- With your other hand, grasp the victim's opposite leg behind the knee. Lift it up without taking your feet off the ground - this allows you to use your foot as a "lever" to make it easier to turn.
- Without changing the position of the arms and legs, move away from the patient and prepare to turn the patient on his side.
Turn
- Pull the raised leg towards you and lay the casualty on their side.
- Remove your hand from under the patient's head, holding the victim's elbow to prevent any movement of the head.
Stabilization
- Adjust the position of the legs - the thigh and knee should be at a right angle.
- Holding the head with one hand, open the patient's mouth with the other and check his breathing.
Steady sideways video
Giving the victim a stable lateral position
Special cases
Pregnant women and obese people are laid on the left side to reduce the risk of squeezing the inferior vena cava. It is responsible for collecting unoxygenated venous blood from the lower parts of the body. When squeezing this vein, there is a risk of worsening the patient's condition.
If the patient lies on his stomach- make sure he is breathing and stabilize his position.
Surveillance of the casualty
Before the arrival of an ambulance, it is necessary to carefully monitor the change in the condition of the victim:
- Control vital functions: breathing, pulse, consciousness.
- Watch for a change in external signs: the appearance of sweat, pallor or cyanosis of the skin.
- When the patient's condition changes inform and check the information for an ambulance.
- Even if the patient is unconscious, talk to him and soothe his.
- Protect from the weather- heat, cold, rain and wind.
- If the victim felt better, and he regained consciousness - wait for the arrival of the doctors and examination by a doctor.
At the scene of the incident and during transportation, the victim must be given an optimal (favorable) position that affects the function of vital organs. This situation depends on the type of injury and the severity of the victim's condition:
In victims who are unconscious due to traumatic brain injury, poisoning, cerebrovascular accident, etc., there is always a danger of retraction of the tongue, and due to inhibition of cough, swallowing reflexes, blockage of the airways by vomit, saliva, sputum, foreign bodies, blood (especially if the victim is on his back). This inevitably leads to impaired lung function in the form of asphyxia (suffocation). To prevent this, the victim must immediately be placed in a stable lateral (drainage) position (Fig. 9).
Fig.9 Drainage position to prevent asphyxia
- Remove goggles from the victim (if any).
- Kneel on the side of the victim. Make sure his legs are straight and his arms are at his side.
- Take the arm closest to you at a right angle to the body, bend it at the elbow so that the palm is pointing up.
- Place the hand farthest from you obliquely on the chest of the victim; Place the back of the victim's hand on the victim's cheek closest to you.
- With your other hand, grab the victim's leg farthest from you under the knee; turn the victim towards you so that the victim's bent knee and foot rest on the ground.
- Extend the victim's head so that the airway remains clear. If necessary, adjust the position of the palm on which the patient's head rests so that the airway remains clear.
- Control the victim's breathing.
Before turning the body, in order to prevent the risk of displacement of the cervical vertebrae (if they are fractured), it is advisable to fix the cervical spine with a cervical splint (Fig. 10).
Fig. 10 Neck splint
The “frog” position is used for suspected trauma to the pelvis, lower extremities. The victim is laid on his back with limbs divorced and half-bent at the knee and hip joints, which rest on a roller in the popliteal region (Fig. 11).
Fig. 11 The position of the "frog" in case of injury of the pelvis and lower extremities
The position on the back with a padded roller is given to the victim with spinal injuries (Fig. 12).
The horizontal position of the body with legs raised by 30 - 40 cm is used for massive blood loss and ongoing internal bleeding (Fig. 14).
What to do if a person is unconscious, BUT breathing?
In this case, it is necessary to ensure the prevention of possible complications (for example, in a victim lying on his back the root of the tongue may sink, which can lead to respiratory arrest; also, if vomiting begins, then the vomit may enter the respiratory tract). To avoid such complications, place an unconscious (or confused) person in a recovery position:
restorative position- This is a position on the side in a stable posture. In this position, the airways are open.
In this position, you can easily put a person of any build and weight, if you know how to do it correctly. So, you need:
1. Remove from the victim and put away everything hanging on his belt: mobile phones, waist bags, knives, etc. It is advisable to do this in front of witnesses so that later you cannot be accused of stealing.
2. Remove and set aside glasses (if the victim is wearing glasses).
3. Remove your mobile phone, glasses, and anything else from your pants pockets that could be crushed or hurt when turned over to the side position. It is advisable to do this in front of witnesses.
4. Sit on your knees on the side of the victim. Place one of your hands under the knee of the victim (on the outside), bend his leg at the knee as much as possible. With the other hand, take the hand of the victim (farthest from you): 
Place the palm of the victim's hand behind his cheek (when you turn the victim to the side position, his cheek will lie in the palm of your hand).
Next, you simply use the victim's bent knee and elbow behind the hand's cheek as a lever, turning the person over: 
Here is a video of how this happens (a video from the same first aid school that I went to):
Despite the fact that for some reason this was not taken into account in the video, in the classroom we were told that we needed make sure that:
- the lower arm is straightened and lies with the palm on the ground;
- the cheek lies on the second hand;
- the nose and mouth are not closed by anything;
- the elbow of the upper arm lies on the ground;
- should not be "foot on foot".
That is, a person should lie as in the picture below, and not as in the video (I don’t even know why there are such discrepancies in the same first aid school):
IMPORTANT: every 20 minutes you need to turn the victim, changing the side on which he lies.
There are various options for a lateral stable position, each of which should ensure the victim's body position on the side, free outflow of vomit and secrets from the oral cavity, and no pressure on the chest (Fig. 19):
A b
V G
Rice. 19. Stages of giving the victim a stable lateral position
- 1. remove glasses from the victim and put them in a safe place;
- 2. kneel down next to the casualty and make sure both legs are straight;
- 3. Take the victim's hand closest to the rescuer to the side to a right angle to the body and bend it at the elbow joint so that its palm is turned up (Fig. 19a);
- 4. move the second hand of the victim through the chest, and hold the back surface of the palm of this hand against the cheek closest to the rescuer (Fig. 19 b);
- 5. With the other hand, grab the victim's leg farthest from the rescuer just above the knee and pull it up so that the foot does not come off the surface (Fig. 19c);
- 6. holding the victim's hand pressed to the cheek, pull the victim by the leg and turn him to face the rescuer in a position on his side;
- 7. Bend the victim's thigh to a right angle at the knee and hip joints to keep the airway open and provide the flask with secrets, tilt the victim's head back. If it is necessary to maintain the achieved position of the head, place the hand of the victim under the cheek (Fig. 19d);
If you suspect spinal injury but must leave the patient, place the patient in a modified stable lateral position.
Straighten his arm above his head, and turn his body so that his head rests on a straightened arm. This position is HAINES (English high arm in endangered spine) (Fig.20)
Rice. 20. Position HAINES
Check for normal breathing every 5 minutes; Move the victim to a lateral stable position on the other side every 30 minutes to avoid positional compression syndrome.