Risks of restraint - learning from tragedy

Maybo estimates that around twenty individuals have died following use of force by security personnel in the UK in the past twelve years.

  • The vast majority of incidents have involved door supervisors in licensed retail settings and often started as straightforward ejections
  • A few tragedies have occurred in retail and hospital settings
  • In almost every case staff had not received formal training in physical intervention
  • Ignorance was more evident than malice
  • In most cases staff acted lawfully at first but failed to mitigate the risks during the subsequent restraint

Cause of death

In many cases the cause of death has not been clear, nor whether the use of force/restraint directly caused it. The majority of deaths appear due to positional asphyxia or cardiac arrhythmia (a heart attack). Lack of training led to poor teamwork and use of physical skills carrying heightened risk. Personal risk factors have included alcohol and drug consumption, and the underlying state of health of the individual concerned. In most cases, however, it is fair to say that the individual would be alive had they not been restrained. Charges of manslaughter have been brought against at least a dozen door supervisors/security officers; mostly where the cause of death has been clear e.g. positional asphyxia.

Control measures

The SIA announcement on mandatory PI training for door supervisors will help to raise awareness of restraint related risks and provide a wider set of low level physical skills to help reduce escalation and high risk restraints.

Many security personnel will need an even higher level of training in physical skills, yet in some of the cases we have reviewed, a basic awareness of the risks with ground restraint and simple steps, like monitoring and communicating with the subject, could have saved lives. 

Mandatory training in PI is a big step forward in staff and public safety but it is vital that employers back this with additional training at higher risk sites, effective supervision and workplace reinforcement. 

These measures will reduce the number of injuries and tragedies, but will not eradicate them.

 Key learning from incidents we have reviewed:

  • The majority of the deaths involved restraint on the ground
  • Several deaths involved pushes or blows resulting in falls and head trauma
  • Neck holds used during ejection resulted in at least two broken necks and were also a factor in some of the ground restraints
  • In some cases restraint caused the death (in particular, those involving positional asphyxia) in others the cause of death was less clear although restraint was established as a contributory factor
  • High risk techniques were often used in ejections and ground restraints - especially compression of the neck and weight/pressure on the torso
  • In some instances staff appeared to mistake an individual’s struggle for breath as aggression
  • Ground restraints were often prolonged, lacked teamwork and communications and monitoring of the well-being of the individual
  • In a number of cases bystanders identified a medical emergency and had to persuade staff to release the individual
  • Many of the tragedies started as straightforward ejections that escalated as force was applied. In some cases it was unclear why the restraint went to ground
  • De-escalation of force often did not occur until it was probably too late
  • Ignorance of technique and medical risks was apparent in many cases reviewed.

The key training messages: 

1. Reduce exposure to risk: Keep trouble out of the venue as far as possible and remove problem individuals using communication skills and safer methods. Think twice before detaining someone. 

2. Don't use force unless you really have to and then use only what is necessary to achieve the lawful objective: It is easier to increase use of force than to reduce it.

3. Avoid holds involving the neck and get proficient in alternatives.

4. Do all you can to keep off the ground and if you have to hold someone there:

  • Constantly monitor their well-being and seek to lighten/de-escalate holds and pressure
  • Show leadership…..don’t wait for someone else to say or do something
  • Move them to a safer position such as seated, the recovery position or kneeling at the earliest opportunity

5. If you work in higher risk venues and roles that involve ground restraints, raise awareness of the risks with your employer and get the next level of training in Additional Holding.


 

Posted by Maybo on March 9, 2012

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