First aid courses normally teach two different ways of rolling someone into the recovery position. One is for an unconscious and breathing casualty and one for an unconscious but breathing casualty who is suspected of having a spinal injury. Professor Keith Porter has developed a new way of rolling someone into the recovery position that makes it easier for one person to roll someone into the recovery position with minimal movement of their spine.


When is the recovery position advised?

The recovery position is essential when a casualty is unconscious and breathing normally. It is a sensible way of positioning someone to allow the tongue to flop forward and any fluids to drain out, ensuring they do not enter the airway.

If the casualty stops breathing normally at any time, or demonstrates agonal breathing, you should start CPR.

Spinal injury

NICE estimate that approximately 700 people sustain a new spinal cord injury (SCI) each year in the UK. In the UK there are currently 40,000 people living with long term disabilities as a result of such injuries.

Helping the casualty to maintain a clear airway is critical and takes priority over any suspected spinal injury. If their airway is blocked they will be unable to breathe. Therefore, to maintain an open airway; anyone who is unconscious and breathing, should be rolled onto their side into the recovery position. Spinal injuries can be unstable and it is vital that in moving the casualty, you don’t cause further damage to the spinal cord.  If there are multiple people able to assist, then supporting the head and neck, and log rolling the casualty may be a better approach to minimise movement to their spine. However, if you are on your own, Professor Keith Porter has developed an alternative approach which is simple and effective. 

It is incredibly important to keep the spine in line and avoid them twisting. It is vital to keep checking the casualty is breathing.

Benefits of new position

  1. Reduces risk of movement to spine and inducing paralysis
  2. Easier for a solo first aider to perform
  • First aider moves to the side of the casualty
  • Cross their legs, bringing the far leg towards you
  • Carefully slide the casualty’s nearest arm under their head with their palm facing upwards

Remember to do this with minimal movement of their head. Best done by using one hand to support their neck whilst sliding their other hand under their head. Slide until the casualties’ head rests on top of their palm.

  • Bring the casualties’ other arm across their chest and towards you
  • Grasp their far shoulder and their hip simultaneously.
  • Pull equally on each to roll the casualty towards you so that they are resting on their side.
  • Adjust the upper leg so that the hip and knee are at a right angle
  • Continually monitor breathing until help arrives – this is absolutely vital


First Aid for Life cover the recovery position on all our practical and online courses.  


Written by Emma Hammett RGN

Award-winning first aid training tailored to your needs

It is strongly advised that you attend a fully regulated Practical or Online First Aid course to understand what to do in a medical emergency. Please visit or call 0208 675 4036 for more information about our courses.

First Aid for Life is a multi-award-winning, fully regulated first aid training provider. Our trainers are highly experienced medical, health and emergency services professionals who will tailor the training to your needs. Courses for groups or individuals at our venue or yours.

First Aid for life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information.

For further information: please read the following:

Keith Porter paper

Evidence around the need for a spinal recovery position


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