Sir – I read Andy Walker's article (‘APR training for security staff’, Career Development, SMT, July 2006) with both great interest and not a little concern. In particular, I noted the absence of the words ‘positional asphyxia’.

Positional asphyxia – also known as ‘restraint asphyxia’ – causes death when the body position of a restrained person interferes with that person’s ability to breathe effectively, and the individual is unable to correct the body position because of physical restraint.

Alcohol or drug intoxication, delirium, obesity and respiratory problems (asthma among them) can increase the risk of positional asphyxia.

For their part, security officers should be competent in basic resuscitation techniques, and be familiar with the ABC doctrine – Airway (free of obstruction), Breathing (an effective flow of air to and from the lungs) and Circulation (the presence of a heartbeat and pulse).

I sincerely hope that all ‘restraint’ courses being offered to security personnel address the risks of positional asphyxia. I also hope that the BSIA and Skills for Security are similarly aware – both in terms of the safety of persons restrained by security staff and the reputation of the profession in general.

Malcolm Cheshire RMN CPN Cert SBCI, Pg Cert Security Management, Executive Director, The Arkwood Centre

Andy Walker replies: I wholeheartedly welcome Malcolm’s query with regards to our new APR (Arrest and Plastic Restraint) training programme, and in particular his concerns relating to ‘positional asphyxia’.

When I was researching other ‘handcuff’-related training being taught to non-police personnel around the UK, I was dismayed at the lack of knowledge-based instruction included on some of the courses.

One I saw gave a brief 15-minute ‘refresher’ on Section 3 of the Criminal Law Act with regards to the use of force when carrying out lawful arrests, and then went straight into the practical sessions of how to apply the equipment.

Our programme, on the other hand, consists of about four hours’ worth of lecture-style presentation on aspects such as Health and Safety legislation, the Human Rights legislation, use of force rules, ACPO guidelines on the use of handcuffs, the Police Complaints Authority (PCA) recommendations on national training standards in the application of restraints, powers of arrest, the Conflict Resolution Model and a section entitled ‘Risks Involved’.

The latter section does indeed cover the various risks to be considered when using any form of mechanical restraints (such as positional asphyxia, excited delirium, acute behavioural disturbance and prone restraints). We also talk about the assorted other factors that can place a detained person at further risk when they are either physically or mechanically restrained – such as weight, age, medical problems and intoxification through drink or drugs, etc – and this is before the delegates have even seen the equipment!

When I look back on my initial police training in 1986, this new programme far surpasses what I was taught then before I was allowed out onto the streets of London with my set of shiny new handcuffs.

I also agree with Malcolm’s comment that “Security officers should be competent in basic resuscitation techniques”. I only wish that more end users insisted on this as a part of the initial contract for a security company to provide officers.

If Malcolm would like to attend one of our courses, I would be more than happy to demonstrate to him that all of his concerns are fully and professionally addressed during the training period.

Source

SMT