Posted By William O'Donnell Hi everyone, I have just been reading the HSE's new guidance on first aid at work. I notice that it still states that if a casualty is breathing they should be placed in the recovery position, and you should send for help. My advice to first aiders has allways been to only place a casualty in the recovery position if you are going to leave them unattended, as you do not have x-ray vision and therefore do not know if they have any internal injuries. Though rolling casualties, needlessly, around the floor with external injuries also does not seem a good idea. Am I right to be telling them this, and if so should we still be issuing guidance to first aiders to place people into this 'magical' recovery position.

Posted By Andy William, My thoughts/opinions on this are; You are usually the only first aider on the scene, at least for some time. Whilst you are performing your body checks, for bleeds, #'s , ID/medi-tags etc, you must ensure that your patients airway remains patent. The only practical way to do this (as a first aider (without airway tubes)) is to place your patient in the recovery position. As has already been said, internal/external injuries that you may suspect are secondary to maintaining an airway. I would purchase an upto date St johns/Red Cross Resusci Council etc First Aid manual and stick to that. Regards Andrew

Posted By Ken Taylor I appreciate William's point on this one - as someone that has been involved with first-aid training and competitions since 1969 and having witnessed numerous attempts by first-aiders to turn casualties into the recovery position. Ultimately the guidance in the first-aid manuals is based upon judgements taken by experts for general application and in specific cases the benefits of an action may be outweighed by the risks. We must, of course, teach to the manuals but it is certainly worth emphasising the vulnerability of cervical vertebrae and the possibility of neck injury. A good first-aider will also, on occasions, need to think constructively and improvise in order to do his/her best for the casualty (eg when trapped in awkward positions where recovery positions or conventional CPR will be difficult if not impossible). It's worth using this opportunity to advise readers to obtain copies of the new leaflet and poster for distribition to their workplaces, first-aiders, nurses, etc.