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Positional Asphyxia George

POSITIONAL/RESTRAINT ASPHYXIAIntroductionThere are techniques of restraint that have been associated with sudden, unexpected deaths. Security personnelmust be aware of the potential dangers and take every precaution to ensure they adopt safe practice. PositionalAsphyxia (restraint asphyxia) can be defined as obstruction of breathing as a result of restraint technique. It occurswhen the position of a person’s body interferes with their ability to breath. If this is not recognised, death can occurfrom asphyxia or suffocation. Any body position that interferes with breathing can cause death.What are the risk factors?Security Officers are often involved in confrontations which may necessitate physically restraining a violent person.If a prone position is required to achieve restraint, some people may have difficulty breathing and even die.The following factors contribute to positional asphyxia deaths:1. Obesity – a large abdomen or “beer belly” means that when the person is prone the contents of theabdomen can be forced upward under the diaphragm restricting breathing.2. Psychosis – stimulant drugs (amphetamines, speed, ‘ICE’, ecstasy) can create an “excited delirium” inwhich the person is paranoid, over excited and potentially violent. The stimulation of the heart can producecardiac rhythm disturbances which can be fatal. In this situation any difficulty breathing can result in suddendeterioration in condition and death.3. Pre-existing physical conditions – any condition that impairs breathing under normal circumstances willput a person at a higher risk when they are physically restrained. Examples are heart disease, asthma,emphysema, bronchitis and other chronic lung diseases.4. Pressure on the abdomen – even a thin person will have difficulty breathing if there is pressure on the abdomen.