Prone restraint simply means that the subject of the restraint is in a face down position. It is not the name of a particular restraint technique as there are many ways to restrain someone face down. All prone holding methods are not unsafe, just as all standing, seated or face up holding methods are not safe.
Put someone in a standing choke hold. That’s a standing restraint, but it is unsafe. Put someone in a face up choke hold, that is a face up restraint, but it is unsafe. If you pile sufficient weight on someone who is held face-up, a catastrophic result can indeed occur. In fact, you are even more likely to resort to adding additional weight because face-up holding methods, no mater how well engineered, lack sufficient mechanical advantage to work, especially when the staff person is not as physically capable as the person being restrained.
Experts on restraint usage have ample documentation (see http://www.thetruthaboutpronerestraint.com/news.php) illustrating how face up restraint is not nearly as safe to either youth or staff as prone restraint as long as the prone restraint (as with any restraint) is done correctly i.e removing weight from the youth’s back and chest and monitoring the youth’s physical and emotional well-being.
When you have a restraint policy or program that is ineffective restraints go up, assaults go up, injuries go up, unsafe conditions go up and workers compensation goes up. A Texas study showed that in a low safety climate staff were 5 times as likely to be assaulted than staff in a high safety climate. Also staff that believed that restraint and seclusion were useful tools (not necessarily that these tools were used) were assaulted 2.5 less frequently. If staff is assaulted1/4 -1/3 less frequently (on average) than other students or residents, the number of assaults increases or decreases exponentially depending on whether you are in a low safety or high safety environment. Maryland is seeing the results of this first hand. Maryland went from a high (or at least higher) safety environment to a lower safety environment and is experiencing an 88% increase in injuries and a 20% increase in assault incidents. The assaults are not only on staff.
Face up or face down, the real issue is chest compression that restricts breathing and not paying complete attention to the physical and emotional well being of the person being restrained during the entire time they are being restrained.
In summary, all of the histrionics about banning prone restraint exacerbates a problem that is easily remedied by thoughtfully designed safety protocols and methods.
Tags: prone restraint