For some conscious patients, there is a position of maximal comfort they will strive to maintain, and every effort should be made to allow them to do so. However, in other patients, including unconscious patients, no specific position seems to be warranted. In those patients, the recovery position provides a few advantages. By having their heads turned and facing slightly downward, the risk of aspiration due to emesis, heavy secretions, or blood is reduced.

In certain cases, having one side down (such as having the injured side of a chest down) is clinically indicated, but in other cases, either side can be lower, and logistical or patient movement considerations may impact the decision about which side should be lower. During transport, it is often difficult to maintain the recovery position and the patient may need to be returned to a supine position.