Protecting the Airway & Spine In 'Unconscious, Suspected Spinal Injured' patients

[Geoff Murray]

Protection of the airway and prevention of further spinal injury in the 'Unconscious, Suspected Spinal Injured' person, either prior to the arrival of trained Ambulance personnel, or in the multiple casualty scenario, has always been a high risk period for these patients.

Obviously if a person has a compromised airway they are going to die, or have their 'quality of life' severely impaired, so it must be adequately maintained.

The rang of options in order to move and protect the airway of an 'Unconscious, Suspected Spinal Injured' person has always been limited when little or no equipment is immediately available. So what can people do?

A new clinically researched recovery position has been developed in order to significantly reduce the chances of further injury, whilst at the same time, maintaining a clear airway.

The *H.A.In.E.S. Recovery Position was developed by a MICA Paramedic from the Metropolitan Ambulance Service, Victoria, Australia, with the sole aim of developing a recovery position for the 'Unconscious, Suspected Spinal Injured Casualty'.

This position was also developed for the 'common-good' of all, and to be used freely as required.

The H.A.In.E.S. Recovery Position has now been clinical researched on two (2) occasions by the Medical Faculty of the University of Melbourne, and the findings published in 'Prehospital & Disaster Medicine, Vol 10, No: 4, Oct-Dec 95 and the European Resuscitation Council's clinical journal, 'Resuscitation' Vol 53, Issue 3, June 2002.

The objectives of the H.A.In.E.S. Recovery Position are as follows:-


1.To significantly reduce the amount of lateral
cervical flexion in a casualty
with 'Suspected Spinal Injury' (particularly
in a pre-hospital setting 'prior' to the
arrival of an Ambulance)

2. To provide the maintenance and protection of
a clear airway

3. To provide a position that is easy for the
rescuer to initiate

4. To offer a stable recovery position

5 To overcome the paranoia associated with not
moving a casualty onto his / her side eg 'in
case they have a spinal injury', which is
evidenced on a regular basis by Ambulance
Paramedics and certificated First Aiders

6 To provide a position for First Aiders and
Ambulance Paramedics as an alternative to
'packaging' an unconscious casualty eg.
immobilising them onto a Spineboard in the
supine position, with it's inherent risks of
aspiration.

7 To provide a recovery position for the
positioning of the 'Unconscious, Suspected
Spinal Injured Casualty' when no spinal
immobilisation equipment is available.

Geoff Murray