The problem with prone restraint?
Restraining someone in the prone position has over the years in several cases been cited as a contributory factor towards someone’s death, so is prone restraint safe and should we be using it?
Firstly prone restraint by itself with no other contributory factors can be safe for the aggressor and is definitely safe for the person responding to the aggression i.e. YOU, a person is easier to control if they are on the floor.
Yes placing someone face down on the floor and restricting their movement if they have a pre existing medical condition such as obesity, pregnancy, heart disease, asthma COPD, earlier stroke etc can elevate the risk of death due to positional asphyxia so I would recommend that anyone who has to restrain people as part of their employment / role be given adequate first aid training but more importantly training in ‘Signs of Medical Emergency’, there is a common myth that if someone is talking to you then they can breathe, maybe not! When you are talking you are expelling air out of your lungs, if your upper body is being restricted to prevent that expelled air being replaced then you are not breathing!
Many government agencies use face down restraint and do not have many problems but this is down to the training they receive on medical emergencies and more importantly they monitor the person they are restraining and should they be concerned then appropriate action is taken.
For face down restraint to be safer follow these simple rules.
- The amount of time someone is kept under restraint face down should be kept to a minimum and ideally look at reducing the length of time needed by the application of handcuffs.
- No undue pressure should be applied to the persons back, the rise and fall of the chest and abdomen must not be impeded.
- Monitor the person for the following; Saying they can’t breathe, complaining of nausea, vomiting, foaming at the mouth, sudden passivity, abnormal tolerance to pain, abnormal strength, marked expansion of the veins on the neck etc, and if present then take action.
When you restrain someone you are legally responsible that their physical condition remains unchanged from start to finish, i.e. at the end they are in roughly the same condition as when you first took hold of them, obviously if they are struggling and actively resisting then your safety needs to be managed.
By far the simplest way of protecting the person you are restraining is by the application of handcuffs.