Physical Control in Care Training Manual - Independent Advisory ...

PHYSICAL CONTROL IN CAREUnconsciousness may be followed by aspiration ofvomit/compromise of airway.• Pre-existing heart conditions. It is possible for heart conditionsto go undetected until it is too late - examples are apparentlyhealthy young people suddenly collapsing during sports orphysical exercise• Psychotic states (see Psychosis section later in this manual)• Presence of an excited delirium state (see Excited Deliriumsection later in this manual)• The individual becoming more aggressive due to a personalfear or misguided opinion of staff intention – for example abelief that staff intend to kill them.• A combination of chest-wall or abdominal restriction in a seated,kneeling or leaning forwards position (this is particularlydangerous). Young people must be kept as erect as possiblewhen they are being restrained in a seated position.• Any covering of the airway (nose/mouth) by clothing, towels, oranything else which may restrict breathing; if the young personis in the supine (face up) position and spits at staff there may bea temptation to cover the face with towels, clothes etc. Thismust be avoided as it reduces their ability to breath. A saferalternative is to protect the staff with full-face visors andprotective clothing.Important warning signsThere are a number of important asphyxia warning signs:• An individual struggling to breathe/laboured breathing• Complaining of being unable to breathe. Young people maycomplain of being unable to breathe to get staff to release therestraint. Staff should never presume this to be the youngperson’s intention and should immediately release / modify therestraint to reduce a body / wall restriction. Verbal complaints ofbeing unable to breathe may be accompanied by increasedstruggling as the young person experiences fear/panic.• Evidence or report of individual feeling sick / vomiting• Swelling, redness or blood spots to face or neck© National Offender Management Service National Tactical Response GroupJuly 201033