About Trainers’ Corner
This clip is part of Trainers’ Corner, our new video series where our instructors talk through real first aid scenarios in a natural, relaxed way
These videos are designed to give you the kind of insight you’d get in a real training room – simple, practical techniques explained by the people who use them every day.
If a casualty is unconscious but breathing, the recovery position is essential. But what happens if you think they may have injured their neck or spine? Many people worry about moving the casualty at all for fear of causing more damage, but in first aid, airway and breathing always come first.
If the casualty is on their back, their airway may be at risk. You may see coughing, spluttering, vomiting, or hear breathing that doesn’t sound right. In cases like this, you must still roll them into a safe, side-lying position, but you should do it as gently and carefully as possible.
Why this adapted recovery position matters
Steve explains that although the typical recovery position uses the knee as a lever, this creates a twist through the spine. When a spinal injury is suspected, you want to avoid twisting or bending the neck.
This adapted method keeps the head, neck, and spine aligned during the roll.
Before you move the casualty
Check the surrounding area and remove anything that could cause harm during the roll, including:
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Glasses
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Sharp jewellery
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Tools
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Objects in pockets
Place any personal items safely to one side so you can return them afterwards.
How to protect the spine during the roll
Steve demonstrates:
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Placing the casualty’s hand gently under their cheek to support their head
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Aligning the legs and arms as closely as possible
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Moving slowly and carefully, supporting the elbow and shoulder
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Keeping the movement controlled so the casualty rolls as one unit
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Adjusting the head and mouth to create a clear airway
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Ensuring vomit or fluids can drain away safely
Once in position, the tongue falls to the side, helping keep the airway open.
Call for help
With a suspected spinal injury, you should call an ambulance immediately. If you haven’t already, do it now. Stay with the casualty, monitor their breathing, and keep them warm and reassured.
Want to learn this technique in person?
This recovery position is taught as part of our first aid courses. You can train at our Exeter centre or we can come to your workplace for group bookings.
We also offer flexible e-learning options for individuals and teams.
