Recovery position for generalised seizures: A focused scoping review of guidelines and original research.

OBJECTIVE: A consensus regarding the use of the recovery position (RP) for generalised seizures is lacking. This study aimed to explore corresponding recommendations presented in first aid guidelines and to review original research that may support or refute the application of this manoeuvre for seizures.

METHODS: Guidelines on first aid were identified using PubMed, Google Scholar and Google Search. Articles presenting original data on the use of the RP for seizures were obtained through PubMed and Google Scholar. Relevant data were analysed descriptively.

RESULTS: Of the 26 guidelines found online, 13 provided recommendations on first aid for seizures. The recommendations concerning the use of the RP were conflicting. Five guidelines advised putting the person on their side during the convulsion, and the same number of documents recommended doing it only after the seizure stops. The literature search showed the paucity of original research on this issue. There is no evidence confirming that lateral positioning of a person with continuing seizures reduces the severity of respiratory disturbances or the likelihood of aspiration. However, putting the person with ongoing convulsions on their side can result in potentially disabling and surgery demanding shoulder dislocations and hinder recognition of cardiac arrest.

CONCLUSIONS: Unless compelling new evidence proves otherwise, recommending the placement of the person with continuing seizures in the RP should be avoided and actively discouraged. In the postictal period, the use of the RP for an unresponsive, normally breathing person is advisable as it can prevent life-threatening respiratory disturbances.