Positional Asphyxia and Restraint or Seclusion
The prone position (face down) should not be used for restraint as it may lead to positional asphyxia “Positional asphyxia is insufficient intake of oxygen as a result of body position that interferes with one’s ability to breathe”
(Mohr & Mohr, 2000, p.289;National Institute of Justice Program [NIJP], 1995, p.1)
As a consequence of the restraint application respiration is compromised causing insufficient oxygen in the blood to meet the body’s oxygen needs or demands (hypoxia) which then results in a disturbed heart rhythm (cardiac arrhythmia)(Patterson,et.al., 1998, p.62).
Prone Restraint Complications
Compression or restriction of movement of the ribs (intercostal muscles) limits the ability to expand the chest cavity and breathe
Abdominal organs may be pushed up, restricting movement of the diaphragm and further limiting the available space for the lungs to expand
Further restriction of the chest cavity may come from a staff person pressing a hand or knee into the patient’s back or leaning body weight into or against the back or chest
Agitation or aggressive struggle further increases the body’s oxygen demands and increases the heart rate
Increased heart rate and insufficient oxygen may cause a fatal cardiac arrhythmia
from:
Prevention, Intervention and Postvention: Restraints and Seclusion - ppt download
Additional material of interest at link above.