Editing Positional asphyxia (section)

==Background==
A 1992 article in ''The American Journal of Forensic Medicine and Pathology''<ref name="Reay_1992">{{Cite journal| doi = 10.1097/00000433-199206000-00002| issn = 0195-7910| volume = 13| issue = 2| pages = 90–97| last1 = Reay| first1 = D. T.| last2 = Fligner| first2 = C. L.| last3 = Stilwell| first3 = A. D.| last4 = Arnold| first4 = J.| title = Positional asphyxia during law enforcement transport| journal = The American Journal of Forensic Medicine and Pathology| date = June 1992| pmid = 1510077 }}</ref> and a 2000 article in ''The American Journal of Forensic Medicine and Pathology'' said that multiple cases have been associated with the hogtie or hobble prone restraint position.

The [[New York Police Department]]'s guidelines, explaining protocols for mitigating in-custody deaths, were published in a 1995 [[United States Department of Justice|Department of Justice]] bulletin on "positional asphyxia."<ref name="ncjrs_1995">{{cite report |title=Positional Asphyxia—Sudden Death |url=https://www.ncjrs.gov/pdffiles/posasph.pdf |date=1995}}</ref><ref name="NYT_20141204">{{Cite news| issn = 0362-4331| author = The Editorial Board| title = It Wasn't Just the Chokehold| work = [[The New York Times]]| access-date = June 8, 2020| date = December 4, 2014| url = https://www.nytimes.com/2014/12/05/opinion/eric-garner-daniel-pantaleo-and-lethal-police-tactics.html}}</ref> The NYPD recommended that, "[a]s soon as the subject is handcuffed, get him off his stomach. Turn him on his side or place him in a seated position."<ref name="ncjrs_1995"/><ref name="NYT_20141204"/> A 1996 FBI bulletin said that many law enforcement and health personnel were being taught to avoid restraining people face-down or to do so only for a very short period of time.<ref name="ncjrs_Reay_1996">{{cite journal |last=Reay |first=D.T. |date=1996 |title=Suspect Restraint and Sudden Death |journal=Law Enforcement Bulletin |location=[[Quantico, Virginia]] |url=https://www.ncjrs.gov/App/Publications/abstract.aspx?ID=161292}}  via Federal Bureau of Investigation</ref>

Resuscitation of persons who exhibit cardiac arrest following restraint has proven to be difficult, according to a 1995 article in ''[[Annals of Emergency Medicine]]''. Even in cases where the subject was in the immediate care of paramedics, resuscitation has failed and the subject has died.<ref name="Stratton_1995">{{Cite journal| doi = 10.1016/s0196-0644(95)70187-7| issn = 0196-0644| volume = 25| issue = 5| pages = 710–712| last1 = Stratton| first1 = S. J.| last2 = Rogers| first2 = C.| last3 = Green| first3 = K.| title = Sudden death in individuals in hobble restraints during paramedic transport| journal = Annals of Emergency Medicine| date = May 1995| pmid = 7741355 |url=https://pubmed.ncbi.nlm.nih.gov/7741355 }}</ref> A March 1999 article in the ''Academic Emergency Medicine'' journal reported that one group of doctors had presented a method of resuscitation, correcting [[acidosis]] in the blood of the victim, which proved effective in their small scale study.<ref>{{Cite journal| doi = 10.1111/j.1553-2712.1999.tb00164.x| issn = 1069-6563| volume = 6| issue = 3| pages = 239–243| last1 = Hick| first1 = J. L.| last2 = Smith| first2 = S. W.| last3 = Lynch| first3 = M. T.| title = Metabolic acidosis in restraint-associated cardiac arrest: a case series| journal = Academic Emergency Medicine| date = March 1999| pmid = 10192677| doi-access = free}}</ref> A 2010 article in the ''Journal of the Tennessee Medical Association'' reported a single case of successful resuscitation using "aggressive sedation", "ventilatory assistance" among other interventions but added that "avoiding hobble and prone restraint positions may eliminate some of the problems".<ref>{{Cite journal| issn = 1088-6222| volume = 103| issue = 10| pages = 37–39| last1 = Alshayeb| first1 = Hala| last2 = Showkat| first2 = Arif| last3 = Wall| first3 = Barry M.| title = Lactic acidosis in restrained cocaine intoxicated patients| journal = Tennessee Medicine: Journal of the Tennessee Medical Association| date =December 2010| pmid = 21186707}}</ref>

In 1997 ''[[Annals of Emergency Medicine]]'' article reported on a single small laboratory study in which "15 healthy men ages 18 through 40 years" were placed in the "hobble" or "hog-tie" restraint position. Researchers found that the effects of restraint on the breathing and oxygen levels these 15 healthy men, was limited.<ref>{{Cite journal| doi = 10.1016/s0196-0644(97)70072-6| issn = 0196-0644| volume = 30| issue = 5| pages = 578–586| last1 = Chan| first1 = T. C.| last2 = Vilke| first2 = G. M.| last3 = Neuman| first3 = T.| last4 = Clausen| first4 = J. L.| title = Restraint position and positional asphyxia| journal = Annals of Emergency Medicine| date = November 1997| pmid = 9360565}}</ref>

A 2002 review of the literature published in the ''[[British Journal of Forensic Practice]]'' said that restraining a person in a face-down position is likely to cause greater restriction of breathing than restraining a person face-up.<ref>Parkes, J. (2002) ‘A Review of the Literature on Positional Asphyxia as a Possible Cause of Sudden Death During Restraint.’ British Journal of Forensic Practice. 4(1) 24–30.</ref>

A 2008 article in ''[[Medicine, Science and the Law]]'' said that 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.<ref>{{Cite journal| doi = 10.1258/rsmmsl.48.2.137| issn = 0025-8024| volume = 48| issue = 2| pages = 137–141| last1 = Parkes| first1 = John| last2 = Carson| first2 = Ray| title = Sudden death during restraint: do some positions affect lung function?| journal = [[Medicine, Science and the Law]] | date = April 1, 2008| pmid = 18533573| s2cid = 46557450}}</ref>

In the United States, there were 16 reported deaths in police custody between 1998 and 2009 in which restraint was a "direct or contributory factor to the death." The investigation into the deaths resulted in a 2010 report tabled by the Independent Police Complaints Commission (IPCC).<ref name="TBIJ_Bell_20120131">{{Cite web| title = Police guidelines permit techniques that can kill |first=Dan |last=Bell |work=The [[Bureau of Investigative Journalism]] (TBIJ)| access-date = June 7, 2020|url=http://www.thebureauinvestigates.com/2012/01/31/police-guidelines-fail-to-ban-restraint-techniques-that-can-kill| date = January 1, 2012| archiveurl = https://web.archive.org/web/20130127021943/http://www.thebureauinvestigates.com/2012/01/31/police-guidelines-fail-to-ban-restraint-techniques-that-can-kill/ |archivedate=January 27, 2013}}</ref>

Prolonged (particularly resisted) restraint, obesity, prior cardiac or respiratory problems, and the use of illicit drugs such as cocaine can increase the risk of death by restraint, according to a 2001 article in ''American Journal of Emergency Medicine''.<ref name="Stratton_2001">{{Cite journal| doi = 10.1053/ajem.2001.22665| issn = 0735-6757| volume = 19| issue = 3| pages = 187–191| last1 = Stratton| first1 = S. J.| last2 = Rogers| first2 = C.| last3 = Brickett| first3 = K.| last4 = Gruzinski| first4 = G.| title = Factors associated with sudden death of individuals requiring restraint for excited delirium| journal = The American Journal of Emergency Medicine| date = May 2001| pmid = 11326341 | citeseerx = 10.1.1.620.1614}}</ref>

Positional asphyxia is not limited to restraint in a face down position according to a 2011 article in ''Medicine, Science, and the Law''. Restraining a person in a seated position may also reduce the ability to breathe, if the person is pushed forwards with the chest on or close to the knees. The risk will be higher in cases where the restrained person has a high [[body mass index]] (BMI) and/or large waist girth.<ref>{{Cite journal |doi=10.1258/msl.2011.010148 |issn=0025-8024 |volume=51 |issue=3 |pages=177–181 |last1=Parkes |first1=John |last2=Thake |first2=Doug |last3=Price |first3=Mike |title=Effect of seated restraint and body size on lung function |journal=Medicine, Science, and the Law |date=July 2011 |pmid=21905575 |s2cid=28631704 |url=https://pubmed.ncbi.nlm.nih.gov/21905575/ }}</ref>

A 2012 series by the [[Bureau of Investigative Journalism]] (TBIJ) reported that, since the late 1990s, coroners used the term ''[[excited delirium]]'' to explain restraint-related deaths involving police officers.<ref name="TBIJ_20120213">{{Cite web| title = Excited delirium case list |work=The [[Bureau of Investigative Journalism]] (TBIJ)| access-date =June 7, 2020| archivedate = January 27, 2013|url=http://www.thebureauinvestigates.com/2012/02/13/excited-delirium-case-list| archiveurl = https://web.archive.org/web/20130127021931/http://www.thebureauinvestigates.com/2012/02/13/excited-delirium-case-list/|date=February 13, 2012 |first1=Charlie |last1=Mole |first2=Angus |last2=Stickler}}</ref> A May 1997 article in {{lang|de|Wiener klinische Wochenschrift}} said that deaths in real life situations occur after [[excited delirium]], which had not been studied in laboratory simulations at that time.<ref>{{Cite journal| first1 = M| last1 = Roeggla| first2 = A| last2 = Wagner| first3 = M| last3 = Muellner|first4 = A| last4 = Bur| first5 = H| last5 = Roeggla| first6 = Mm| last6 = Hirschl| first7 = An| last7 = Laggner|first8 = G| last8 = Roeggla| title = Cardiorespiratory Consequences to Hobble Restraint| journal = Wiener klinische Wochenschrift| date = May 23, 1997| volume = 109| issue = 10| pages = 359–61| pmid = 9200808}}</ref>