Recovery position (RP; otherwise known as the lateral decubitus, lateral recumbent or side-lying position) is a widely known first-aid manoeuvre recommended for the management of persons with decreased responsiveness of nontraumatic origin who are breathing normally [1]. Expected health-protecting effects of the RP include the prevention or reduction of aspiration, airway obstruction and related respiratory disturbances [1,2].

The systematic review undertaken by the International Liaison Committee on Resuscitation (ILCOR) to evaluate the efficacy of the RP compared with other positioning strategies as regards their influence on health outcomes showed a lack of conclusive evidence [3]. The ILCOR's experts suggested that the applicability of placing a person in the RP may depend on the aetiology of the decrease in the responsiveness level. In particular, the RP is not recommended for the management of persons with severe trauma (including neck, back, hip, or pelvic injury) or victims with imminent cardiac arrest [1,4].

Generalised tonic-clonic seizures are accompanied by loss of consciousness and may be complicated by life-threatening respiratory abnormalities [5]. Some authoritative guidelines on first aid recommend positioning the person with generalised seizures onto their side. However, the recommendations seem to be inconsistent and sometimes contradictory, particularly in terms of whether the RP should be attempted when seizures are continuing [6] or in the postictal period [7]. The lack of a consensus on the best practice of care suggests the need for systematically reviewing and synthesising available recommendations and research evidence on the efficacy and safety of the RP for generalised seizures, but this has not been done yet.

This focused review aimed to evaluate the recommendations concerning the application of the RP for convulsions provided in first aid guidelines and to weigh the pros and cons of implementing the manoeuvre for generalised seizures based on the evidence presented in peer-reviewed literature.