Proning: Outcomes of Use of Force Followed With Prone Restraint

Abstract

Background: EMS and police are often faced with violent subjects that require the use of force and the application of restraints. After gaining control and restraining subjects, he or she can be physically placed into a number of positions including prone, supine, on their side or sitting. However, due to cases of sudden death of restrained individuals, there has been increased scrutiny towards the positions in which a subject is left after he is restrained. Methods: This was an evaluation of prospectively collected data from a single law enforcement agency for all subjects in which a use of force was utilized during a one year study period. Data collected includes whether the patient was agitated, resisting arrest, the level of resistance the subject demonstrated and how long the subject resisted for after being placed in his final restraining position. Results: Of 2431 use of force incidents, 1535 (63.1%) patients ended up being placed in a prone restraint position, 43 (1.7%) were restrained lying face up, 64 (2.7%) were placed on their sides and 224 (9.2%) were placed in a sitting position. Of all of the subjects who were restrained, 1863 (76.6%) incurred no injuries. 354 (14.6%) subjects were treated at a hospital and then cleared for discharge. No fatalities were noted in any subjects of the research population. Conclusion: Use of force incidents commonly result in individuals placed in a prone restraint position, however, we found no fatalities of individuals placed in a prone restraint position.