Physical restraint

Physical restraint
Intervention
Wrist cuffed to chain
MeSH	D012149

Physical restraint refers to the practice of rendering people harmless, helpless or keeping them in captivity by means such as handcuffs, fetters, straitjackets, ropes, straps, or other forms of physical restraint. Alternatively, unarmed combat techniques or sheer force of numbers may be used to restrain a person.

Contents 1 British police use 2 Purpose 3 Misuse and risks 4 References 5 See also

British police use

British Police officers are authorised to use leg and arm restraints, if they have been instructed in their use. Guidelines set out by the Association of Chief Police Officers dictate that restraints are only to be used on subjects who are violent while being transported, restraining the use of their arms and legs, minimising the risk of punching and kicking. Pouches carrying restraints are usually carried on the duty belt, and in some cases carried in police vans.

For restraint for medical or psychiatric purposes, see medical restraint.

Purpose

In America, physical restraint may be used:

• by police to arrest and detain criminals
• by specially-trained teachers or teaching assistants to restrain children and teenagers with severe behavioral problems, to prevent hurting others or themselves

1. approximately 70 % of teachers who work with students with behavioral disabilities use a type of physical restraint (Goldstein & Brooks, 2007)
2. often used in emergency situations or for de-escalation purposes (Ryan & Peterson, 2004)
3. many educators believe restraints are used to maintain the safety and order of the classroom and students, while those who oppose their use believe they are dangerous to the physical and mental health of children and may result in death (McAfee, Schwilk & Miltruski, 2006) and (Kutz, 2009).
4. Individuals with Disabilities Education Act has stated that "Restraints may not be used as an alternative to adequate staff" (McAfee, Schwilk & Miltruski, 2006, p. 713). Also, "restraint may be used only when aggressive behavior interferes with an individual's own ability to benefit from programming or poses physical threat to others" (McAfee, Schwilk & Miltruski, 2006, p. 713)

• by escapologists, illusionists and stunt performers
• to restrain people who are suffering from involuntary physical spasms, to prevent them from hurting themselves (see medical restraints)
• controversially, in psychiatric hospitals

1. restraints were developed during the 1700s by Philippe Pinel and performed with his assistant, Jean-Baptiste Pussin in hospitals in France

• as part of games of BDSM and sexual bondage
• by a kidnapper (stereotypically with rope or duct tape and a gag) or other material

Misuse and risks

Restraining someone against their will is generally a crime in most jurisdictions, unless it is explicitly sanctioned by law. (See false arrest, false imprisonment).

The misuse of physical restraint has resulted in many deaths. Physical restraint can be dangerous, sometimes in unexpected ways. Examples include:

• postural asphyxia
• unintended strangulation
• death due to choking or vomiting and being unable to clear the airway
• death due to inability to escape in the event of fire or other disaster
• death due to dehydration or starvation due to the inability to escape
• cutting off of blood circulation by restraints
• nerve damage by restraints
• cutting of blood vessels by struggling against restraints, resulting in death by loss of blood
• death by hypothermia or hyperthermia whilst unable to escape

For these and many other reasons, extreme caution is needed in the use of physical restraint.

Gagging a restrained person is highly risky, as it involves a substantial risk of asphyxia, both from the gag itself, and also from choking or vomiting and being unable to clear the airway. In practice, simple gags do not restrict communication much; however, this means that gags that are effective enough to prevent communication are generally also potentially effective at restricting breathing. Gags that prevent communication may also prevent the communication of distress that might otherwise prevent injury.

References

Goldstein & Brooks, S., R.B (2007). Understanding and managing children's classroom behavior: Creating sustainable, resilient classrooms.. John Wiley & Sons, Inc.. 

McAfee, Schwilk, & Mitruski, J., C., & M. (2006). Public policy on physical restraint of children with disabilities in public schools. "Education and Treatment of Children". 

Ryan & Peterson, J. & R. (2004). Physical restraint in school. "Behavioral Disorders". 

Kutz, Gregory. "Selected Cases of Death and Abuse at Public and Private Schools and Treatment Centers". Testimony Before the Committee on Education and Labor, House of Representatives, United States Government Accountability Office. United States Government Accountability Office. http://www.gao.gov/new.items/d09719t.pdf. Retrieved 12/8/2012. 

See also

• Prison
• Pin-down scandal