First Aid: Questions about the Recovery Position

I'm a newly trained first aider so I'd say take my advice with a pinch of salt. I wouldn't move a head/spinal injury at all. Only tilt head up if airway is blocked. Try and remove sharp objects with gloves but only if comfortable doing so. Otherwise your safety comes first. Sharps need to go into a sharps bin and if you don't have access to one give it to the paramedics.

We have always been told jaw thrusts are a load of rubbish

Who told you that?! They make a world of difference if done properly.

To elaborate we have been told they are a last resort and that their use can potentially endanger the person who they are used on as well as making them 'man down' ie we can't then put them back into the fight once they recover if the medic clears them which is specific to military considerations. There is not a lot of advantage in using thrusts unless its a stubborn obstruction at which point we wont be able to get them back in anyway so their safety takes priority. Its always the person first and foremost but we try and avoid them to prevent unnecessary casevacs. So rubbish from that perspective. Civvy first aid I have no idea, never done it.

edit - Reason being soldiers are more likely to have problematic materials in their mouths ie shrapnel, phosphorous, other hazardous/reactive/sharp objects so pressing down like that may well kill them. This is why a half tilt is always used to check what the obstruction is before proceeding.

Also if you suspect sharp objects like needles in pockets, do you remove them using gloves or something?

I fail to see how doing a jaw thrust is at all dangerous, let alone may kill someone!

If they got shrapnel caught in their throat during an explosion or have burn centres due to close proximity to chemical detonations ie smoke grenades or signal flares applying pressure pushes it deeper in or shifts some of the chemical causing more damage and potentially death particularly as they may also have exterior shrapnel damage. Thats the basic reason, there is a bit more in detail but cba lol.

Can't tell you a lot about civilian first aid but military procedure is to apply common sense albeit from a reservist so take it with a pinch of salt =P. The airway should be cleared by a chin tilt anyway, if its a liquid obstruction then you're better to use the recovery position or - if you have help - log roll them to clear it. With any spinal injury log rolls are the best principle. If its a gripping obstruction ie you cant clear it by tilting or reaching into their gob then recovery won't help anyway. There's no reason to recovery a spinal injury unless they have a catastrophic bleed or other more pressing issue. We have always been told jaw thrusts are a load of rubbish, if you need them its for biochem burns or extreme blockage like shrapnel (it does happen) but I dont know civilian guidance. A half tilt can be used, just open their mouth and check for obstructions - if there are none then all is good, if there are some then thats priority so do a full tilt. Again all common sense really.

As for sharp objects remove them if you can but dont risk yourself. You dont need a special bag or anything just get them out of the way. We had someone get injured with a knife in their smock pocket whilst training and it just got lobbed into the grass so we could treat them. Be more cautious depending on the situation ie if its a drug addict who has collapsed make 100% sure not to stab yourself removing the syringe

First aid taught to non-medics in the military is not exactly useful to the OP who presumably is a civilian.

As to your point about chin lifts being useful i presume you're in a role which doesn't use airway adjuncts as the evidence for the use of a jaw thrust in the setting of a suspected high spinal injury is pretty conclusive and an airway adjunct removes the requirement for a person to remain at the head end.

Sounds like complete nonsense to me!

I know, it got dragged out of context when i gave basic advice. Gotta love the internet =P

Nope, thats combat medic. We do get some of their training as specialised infantry as we are expected to operate out of range of medics but thats basically above my understanding. I know what one is and our issue packs have a tube for creating one but its really not recommended, its if we have literally no other choice especially with the normal types of damage sustained.



Well tell that to a ten year veteran of the medics corps brought in specifically to teach us =P It might be but I'm not going to argue with him lol.

You don't need a tube to "create" a jaw thrust. I think you might be getting something mixed up. There's also no way a jaw thrust alone would force anything further into anyone's airway.

No i meant we have tubes to create an adjunct. The pressing down motion supposedly can cause further damage if there are sharp objects lodged due to the nature of the press putting pressure on the face, this becomes particularly relevant if there is exterior damage also as there tends to be if someone gets caught in an explosion.

I'm sorry I replied now lol, I have rudimentary combat first aid skills and everyone is telling me off

I realise that you've borne the brunt of this, but I do think somewhere along the line in your teaching something has got confused. A jaw thrust doesn't involve a "pressing down motion" on the face - it's all about lifting the lower jaw up and away. Applied properly, it is a potentially lifesaving manoeuvre, even in someone with external or internal injuries/foreign bodies - though they are likely to need more definitive airway management anyway, you can buy time with simple moves.

I'm not quite sure what you're envisaging when talking about jaw thrusts, or why they would particularly make someone "man down" compared with other moves. If someone is injured enough to need airway protection, they aren't going to be returning to combat any time soon no matter what you do to them.

In answer to the OP's question, jaw thrust is one option, though the patient needs to be pretty deeply unconscious to tolerate it. Alternatively log rolling is still an option and as Zippy says, over-zealous C-spine protection is going out of fashion now (though don't say this in an exam!)

COI: I'm an anaesthetist, so airway management is pretty much my thing. I don't do combat medicine but do handle civilian major trauma and understand enough of the principles to know when something just doesn't make sense!