Physical Restraint and Near Death of a Psychiatric Patient
- 15 October 2012
- journal article
- case report
- Published by Wiley in Journal of Forensic Sciences
- Vol. 58 (1), 259-262
- https://doi.org/10.1111/j.1556-4029.2012.02290.x
Abstract
Physical restraint is used as a last resort emergency measure to calm and safeguard agitated and/or aggressive psychiatric patients. This can sometimes cause injuries, and rare fatalities have occurred. One mechanism of injury and death while in physical restraint is that of severe asphyxiation. We present the case of a hospitalized man in his mid-30s, suffering from schizophrenia. The patient was obese. He became aggressive and had to be manually restrained with a "takedown." After having been put in the prone position on the floor with a significant weight load on his body, he lost respiration and consciousness. Subsequently, he was given CPR. He regained consciousness and respiration, while the cyanosis receded in 1-2 min. Psychiatrists and pathologists should be aware that physically restraining a patient in the prone position with a significant weight load on the torso can, in rare cases, lead to asphyxiation.Keywords
This publication has 33 references indexed in Scilit:
- Nonchemical Suffocation Deaths in Forensic Setting: A 6‐Year Retrospective Study of Environmental Suffocation, Smothering, Choking, and Traumatic/Positional Asphyxia*Journal of Forensic Sciences, 2010
- Treatment of schizophrenia with antipsychotics in Norwegian emergency wards, a cross-sectional national studyBMC Psychiatry, 2009
- Ventilatory and Metabolic Demands During Aggressive Physical Restraint in Healthy AdultsJournal of Forensic Sciences, 2007
- Use of Pulse Oximetry During Restraint EpisodesPsychiatric Services, 2005
- Restraint AsphyxiaAmerican Journal of Forensic Medicine & Pathology, 2000
- Restraint AsphyxiaAmerican Journal of Forensic Medicine & Pathology, 2000
- Restraint Position and Positional AsphyxiaAmerican Journal of Forensic Medicine & Pathology, 1999
- Positional AsphyxiaAnnals of Emergency Medicine, 1998
- Sudden Death in Individuals in Hobble Restraints During Paramedic TransportAnnals of Emergency Medicine, 1995
- Positional Asphyxiation in AdultsAmerican Journal of Forensic Medicine & Pathology, 1992