Positional Asphyxia - Prone Restraint

Prone Restraint

Research has suggested that restraining a person in a face down position is likely to cause greater restriction of breathing than restraining a person face up. Multiple cases have been associated with the hogtie or hobble prone restraint position. Many law enforcement and health personnel are now taught to avoid restraining people face down or to do so only for a very short period of time.

Risk factors which may increase the chance of death include obesity, prior cardiac or respiratory problems, and the use of illicit drugs such as cocaine. Almost all subjects who have died during restraint have engaged in extreme levels of physical resistance against the restraint for a prolonged period of time. Other issues in the way the subject is restrained can also increase the risk of death, for example kneeling or otherwise placing weight on the subject and particularly any type of restraint hold around the subject's neck. Research measuring the effect of restraint positions on lung function suggests that restraint which involves bending the restrained person or placing body weight on them, has more effect on their breathing than face down positioning alone.