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The H.A.I.N.E.S. Recovery Position


Modified - H.A.IN.E.S. Recovery Position

The modified H.A.IN.E.S. Recovery Position (H.A.IN.E.S. is an acronym for High Arm IN Endangered Spine), offers an even better alternative for airway and spinal protection for the 'Unconscious, Suspected Spinal Injured' casualty. This *clinically researched position not only protects the casualty's airway, but also significantly reduces the amount of side-ways movement (lateral flexion) of the head and neck.

National Recognition for H.A.IN.E.S. Recovery Position

This position, which was conceived and further developed by our Managing Director, John Haines in 1989 has been clinically proven to reduce lateral cervical flexion (sideways movement of the head and neck) by comparison to the more commonly known Lateral Recovery Position, which was used as the benchmark for comparisons during the two studies.

The American Heart Association (AHA), which is the largest resuscitation organisation in the world and the American Red Cross also gave formal recognition to this position back in 2005.

Placing casualties into the H.A.IN.E.S. recovery position:



H.A.I.N.E.S Pic 01

1. With the unconscious casualty lying supine (on their back), kneel beside the casualty's waist. The casualty's arm furthest away from the first aider should then be fully raised by 'rotating it outwards' to ensure it is beside the casualty's head. This is achieved automatically by ensuring the palm is facing upwards.
H.A.I.N.E.S Pic 02

2. The casualty's upper limb nearer to the rescuer is placed across the chest, with fingers pointing to the opposite shoulder.
H.A.I.N.E.S Pic 03

3. Flex (bend) the casualty's nearest lower leg at the knee.
H.A.I.N.E.S Pic 04

4. The first aider's forearm nearest to the casualty's head and neck, is then carefully placed under the casualty's nearest shoulder to provide extra leverage, and to avoid pushing on the head and neck.
H.A.I.N.E.S Pic 05

5. The rescuer's hand (of the stabilising arm at head end) is then placed under the hollow of casualty's neck and head to provide stabilisation ONLY. DO NOT push/lift the casualty's head or neck.
H.A.I.N.E.S Pic 06

6. The casualty is then carefully rolled away from the rescuer, by simultaneously pushing on the casualty's nearest shoulder with the first aider's forearm of the stabilising hand (DO NOT push on the head or neck), and the casualty's flexed knee (with the rescuer's free hand), ensuring large casualty's do not roll into the prone position.
H.A.I.N.E.S Pic 07

Note: Ensure the head remains in contact with the casualty's raised arm and supported by the First Aider's hand.

7. Whilst still supporting the head and neck, place the hand of the casualty's upper arm 'Palm down', placing the fingers under the Armpit of the underarm.

8. As soon as the hand from the upper arm is placed into the armpit, ensure the Forearm is flat on the surface and is position at 90 degrees to the body.

9. When the casualty is positioned on their side, check the airway and if required, clear with the face turned slightly downwards to permit drainage from the mouth (while still being supported on the raised arm underneath).

Once the casualty is placed into the H.A.IN.E.S. Recovery Position, use airway manoeuvres such as 'Jaw Thrust' (lifting the jaw 'forward' and upward, whilst avoiding pressure on the neck) first, in preference to head tilt in order to further reduce movement to the neck.



Australian First Aid 2003. The above instructions are FREE for public access & use.

* 'How should an unconscious person with a suspected neck injury be positioned?' - B. Gunn et. Al 'Prehospital & Disaster Medicine' - Vol 10, No: 4 Oct-Dec 1995.
'The position of the spine in the recovery position - an experimental comparison between the lateral recovery position and the modified HAINES position' - W. Blake 'Resuscitation'; Vol 53; Issue 3; June 2002.