Ventilatory and Metabolic Demands During Aggressive Physical Restraint in Healthy Adults

Abstract

We investigated ventilatory and metabolic demands in healthy adults when placed in the prone maximal restraint position (PMRP), i.e., hogtie restraint. Maximal voluntary ventilation (MVV) was measured in seated subjects (n 5 30), in the PMRP, and when prone with up to 90.1 or 102.3 kg of weight on the back. MVV with the heaviest weight was 70% of the seated MVV (122 AE 28 and 156 AE 38 L/min, respectively; po0.001). Also, subjects (n 5 27) were placed in the PMRP and struggled vigorously for 60 sec. During the restrained struggle, ventilatory function (V E / MVV) was 44% of MVV in the resting PMRP. While prone with up to 90.1 or 102.3 kg on the back, the decrease in MVV was of no clinical importance in these subjects. Also, while maximally struggling in the PMRP, V E was still adequate to supply the ventilatory needs.

Incidence and outcome of prone positioning following police use of force in a prospective, consecutive cohort of subjects

“…41,42 In our study, we did not systematically record whether any weight force was applied at any time on the subject's back or shoulders, although there is little doubt that it occurred for some of our subjects. The documentation of weight force application will be included as a variable of interest as we continue our study.…”

Evaluation of the Ventilatory Effects of a Restraint Chair on Human Subjects

“…In one study, ventilatory measurements were taken with 50 lbs of weight on the back and there was no evidence of hypoventilation, hypercapnia, or hypoxemia (8). In a related study, there are no clinically significant restrictions of ventilatory reserve when subjects are placed prone with up to 225 lbs of weight on their back (9). Work has not been previously reported with weight on the anterior thorax, as most restraining processes involving police take place with the subject in the prone position.…”

“…Work has not been previously reported with weight on the anterior thorax, as most restraining processes involving police take place with the subject in the prone position. Likewise, when subjects are maximally struggling for 60 s while in a hogtie position, there are no clinically important limitations of metabolic or ventilatory functions (9).…”

Deaths in custody: the role of restraint

“…Michalewicz et al (2007) saw catecholamine hyperstimulation as one of the risk factors of restraint-related deaths.…”