Magazine article Children's Voice

Silent Killer

Magazine article Children's Voice

Silent Killer

Article excerpt

Certain restraint positions can result in positional asphyxia, a condition that occurs when a person's body position interferes with respiration, resulting in suffocation. Any body position that obstructs the airway or interferes with the muscular or mechanical components of breathing may result in positional asphyxia.

For breathing to occur, the central nervous system must activate the respiratory muscles, causing the ribcage to expand and the diaphragm to descend into the abdomen, creating a larger internal chest space. This size change causes the internal chest air pressure to be less than the external air pressure. When the airway opens, this pressure difference causes air to flow into the lungs, producing inhalation.

Relaxing the diaphragm and ribcage muscles results in a smaller chest space, and internal air pressure becomes greater than external air pressure. When the airway opens, the pressure differences causes air to flow out of the lungs, producing expiration. If the internal chest air pressure cannot change because the size of the chest space cannot be changed, no air movement occurs.

When a patient is placed facedown, with forceful compression of the shoulders and chest, chest expansion is seriously restricted or prevented altogether. By forcefully compressing the patient's lower back or hips against a surface, the abdomen is compressed, preventing the diaphragm from descending into the abdomen and changing the size of the chest space. Thus, forceful prone restraint significantly restricts or prevents inhalation. Abdominal fat places overweight individuals at greater risk for interference in breathing and a more rapid onset of restraint asphyxia when forcefully prone restrained.

Often, a patient is restrained after aggressive or violent behavior and extreme physical exertion brought on by alcohol or drug use, traumatic head injury, psychiatric disorders, low blood sugar, or seizures-all of which can result in extreme total body exhaustion. …

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