positional asphyxia restraint

Hightened demand for oxygen. . But as a paramedic, I do know that positional asphyxia doesn’t discriminate. Found inside – Page 537Traumatic asphyxia with neck compression and positional asphyxia. • Asphyxia due to restraint and suffocation. • Asphyxia due to compression ... Pepper spray exposure in 19%. Patient concerns: In this report, we are describing one case of adult who was found positioned in a way that led to eventual asphyxiation. Positional Asphyxia (restraint asphyxia) can be defined as obstruction of breathing as a result of restraint technique. Typically, it occurs in prone positioning of large or obese patients , particularly those with a . Law enforcement agency policies: arrests: positional asphyxia. After Dr. Reay's retraction, little evidence is left that suggests the hogtie restraint can cause asphyxia. Restraint-related positional asphyxia occurs when a person being restrained is placed in a position in which he cannot breathe properly and is not able to take in enough oxygen. Alcohol and high drug use. It should be emphasised that the body requires very little oxygen to make noises from the mouth but needs considerably more to survive during a prolonged struggle or restraint episode. Thus, a person dying of positional or restraint asphyxia may well be able to some extent to communicate prior to collapse or lapsing into unconsciousness. Usually there are no outward signs or symptoms of positional asphyxia. concept of positional asphyxia after conducting experiments. The Dallas medical examiner found his death was due to "positional asphyxia" — being held in a position that compromised his breathing. Book Asphyxiation, Suffocation,and Neck Pressure Deaths. Positional asphyxia is a rare cause of death, responsible for only 1% of all asphyxial deaths in Lithuania and described in just 0.03% of autopsies performed between the years 2010-2016. Ann Emerg Med Ann Emerg Med 1997;30(5):578-586. Restraint is an intrusive and dangerous intervention that can have signi fi cant adverse implications The best management is de-escalation, avoiding prone restraint, restraining for the minimum amount of time, lying the detainee on their side and constant monitoring of vital signs. Restraint position and positional asphyxia. Whether or not the legislation becomes law in California, Thorpe plans to move forward with the issue . As a result, police departments across the country have instituted policies that direct offic-ers to not put weight on a prone subject's back and to L.J. 1. All of the 4 4See Reay et al., "Effects of Positional Restraint on Oxygen Saturation and Heart Rate Following Exercise," 9 Am. The jury found that the cause of his death was positional asphyxia with left ventricular failure following restraint, and epilepsy. In Evaluating Police Uses of Force, legal scholar Seth W. Stoughton, former deputy chief of police Jeffrey J. Noble, and distinguished criminologist Geoffrey P. Alpert explore a critical but largely overlooked facet of the difficult and ... Positional Asphyxia E2 There is a risk of Positional Asphyxia when restraining a person. A recent review by Duxbury et al (2011) found that out of 38 restraint related deaths, 26 deaths were associated with positional asphyxia. Positional asphyxia occurs when a person is placed in a posture that prevents or impedes the mechanism of normal breathing. Restraint position and positional asphyxia. They are what I understand to be basic topics for use of force for security and police personnel. Most reports concern adults who often, but not exclusively, have been in police custody. CrossRef Google Scholar. Positional asphyxia Ann Emerg Med. The issues of prone restraint and positional asphyxia were at the heart of the Derek Chauvin murder trial. Found inside – Page 84This finding suggests that restraints pose an inherent danger to patients ... [emphasis added] Although fatal positional asphyxia has been documented in ... Q Cal. He has also learned, however, "that a number of trainers misunderstand the issues related to positional asphyxia and prone restraint," as he wrote on his blog last fall. 1998 Jul;32(1):116-8. doi: 10.1016/s0196-0644(98)70121-. Found inside – Page 232Accidental positional asphyxia is rarely seen in children. Fatalities during and shortly after police restraint play a quantitatively significant role in ... That’s why it is necessary for law enforcement officers to know and understand that preexisting risk factors combined with the body position of the subject when subdued or while in transport can increase the risk of in-custody death. Most reported cases involve young men in an "excited" state or one of "agitated delirium" as a result of psychiatric illness or intoxication from illegal drugs. “Positional asphyxia” or “restraint asphyxia,” the theories most frequently proposed, are terms often used synonymously. Found inside – Page 153In none of these original cases was the individual physically restrained in the prone or hobble position. Another related form of asphyxia is termed ... You should avoid restraints that carry a heightened risk Positional asphyxia is the medical term for when the body's position prevents adequate oxygen intake, leading to unconsciousness, disturbed heart rhythm, heart attack or death. 26. Dr. Reay found that the hogtie restraint prevents oxygen levels from rising again because the restraint impairs the mechanical process of inhaling and exhaling. Positional asphyxia also may be a result of the policing technique known as "prone restraint", used by police, corrections, military, or health care staff. controlled trial 3.2. 3.1. These techniques involve a person being pinned to the ground, sometimes with a knee placed against their chest or neck. Found inside – Page 133Best Practices Examination of positional asphyxia deaths has revealed that there are ... and bronchitis) tends to be exacerbated by exertion and restraint.1 ... First Published 2020. Restraint Position and Positional Asphyxia Theodore C Chan. Generally, these medical experts will attempt to prove that the cause of death resulted from a theory of “positional or restraint asphyxia” as a result of prone restraint. J Emerg Med 1999;17(5):777-782. April 29, 2020 "positional or restraint asphyxia" assume that prone positioning is . Dr. Reay found that the hogtie restraint prevents oxygen levels from rising again because the restraint impairs the mechanical process of inhaling and exhaling. or "positional asphyxia." Keywords Forensic medicine, medical law, prone restraint, cardiac arrest, restraint asphyxia, restraint physiology, prone asphyxia, cardiac output, metabolic acidosis and police custody death Introduction Physical restraint is used by law enforcement officers (LEOs) and health-care workers when dealing with Positional asphyxia also may be a result of the policing technique known as "prone restraint", used by police, corrections, military, or health care staff.People may die from positional asphyxia accidentally, when the mouth and nose are . clearly harmful, even though all of . First reported in the late 1980s by a Seattle area forensic pathologist named Dr. Donald T. Reay, "restraint asphyxia" reflected the chief medical examiner's determination that you can . Many people have died as a result of positional asphyxia during forceful restraint. 25. Dr. Sometimes called "restraint-related asphyxia" or "positional asphyxia," such deaths have a common theme: the excessive use of force by police causing a person to be deprived of oxygen. Restraint Asphyxia Asphyxiation, the most common cause of restraint-related death, is termed "restraint asphyxia" in the forensic and emergency literature (11). Positional asphyxia risk factors in restraint. In the context of the three-fold fatal levels of fentanyl, however, I don't see how positional asphyxia gets one to guilt beyond a reasonable doubt. Deborah Coles from Inquest, a group which campaigns over deaths in custody, said: "Dangerous restraint methods and neglect caused Mr Moyo's death. Found inside – Page 82Yet another possibility is that the restraint is used , but the child is ... entangled in the straps of the swing , or from positional asphyxiation . Found inside – Page 755Restraint asphyxiation in excited delirium. Am J Foren Med Pathol 1993;14:289–95. Chan TC, Vilke GM, Neuman T, Clausen JL. Restraint position and positional ... Some police trainers . Suspects under restraint may evidence signs of positional asphyxia, Tomlin's father, Paul, said: "As a family we feel the finding of neglect by the jury is a . However physical restraint is not without risks and staff working in areas in which restraint may be required 1230 (S.D. [Clearly, these authors have never ASSUMED THE POSITION! Positional asphyxia is a potential danger of some common physical restraint techniques. Positional asphyxia results from restraining an individual in a position that restricts the physiological functions of ventilation and has also been implicated in restraint related death of individuals in police custody.4 The objective of this report is to review the evidence regarding the safety of physical restraints Read ‘Trans customers: a … If the person cannot get into a safer position, she will die from oxygen deprivation. Mechanism of death Positional asphyxia Stratton et al. Advisory Guidelines for Care of Subdued Subjects Officers are responsible for the safety and well-being of the suspects in their custody and control. There are a number of adverse effects, the more common of which include: inability or difficulty in breathing feeling sick or being sick Although the "old" version of this article remains on this page, in December, 2005, I created and posted a PDF file of this article! Restraint strategies should be used that do not apply pressure to the subjects torso, neck or throat. Positional asphyxia can sometimes be caused by application of various techniques known as ‘prone restraint’. Found inside – Page 272The simultaneous application of handcuffs and leg restraints ('hog-tying') is associated with particular risks of positional asphyxia (see b p.108) and ... the available peer-reviewed . Found inside – Page 125There are several underlying factors associated with this type of death, which include excited delirium, restraint asphyxia, positional asphyxia, ... This can be a problem with people in restraints, very ill patients, infants, and people who . 1 author. 101. Positional asphyxia results from restraining an individual in a position that restricts the physiological functions of ventilation and has also been implicated in restraint related death of individuals in police custody.4 The objective of this report is to review the evidence regarding the safety of physical restraints Thus, the “manner” of death historically attributed to “positional asphyxia” has … Positional asphyxia occurs when there is an insufficient intake of oxygen as a result of the position of the body, and the position consequently interferes with one’s ability to breathe. Restraint-related positional asphyxia occurs when a person being restrained is placed in a position in which he cannot breathe properly and is not able to take in enough oxygen. Using verbal de-escalation strategies before a situation can turn physical can help you avoid the need to restrain at all. According to an article in USA Today, since 2010, at least 134 deadly police encounters have occurred "in which victims said they couldn't breathe while being . clearly harmful, even though all of . Found inside – Page 172Chan, T. C., Vilke, G. M., Neuman, T. Reexamination of custody restraint position and positional asphyxia. Am. J. Forensic Med. Pathol. 19:201–205, 1998. Chan TC 1, Vilke GM, Neuman T, Clausen JL. 1998), two doctors faced off on the issue of positional asphyxia. They are what I understand to be basic topics for use of force for security and police personnel. Get Training. Whilst the risk of death from positional asphyxia during restraint has been increasingly recognised, harm can also occur in the period following restraint from the effect of illicit substances, alcohol, prescribed medications (including any rapid tranquilisation) and co-existing medical conditions. If the person cannot get into a safer position, she will die from oxygen deprivation. Risks of Physical Restraint and Positional Asphyxia -Guidance In some circumstances physical restraint is the only option available to staff to protect the patient or others from serious harm. They also identified failures to communicate "significant information" and follow procedures. Meirion was 53 years old when he died and was a dearly loved son, brother and uncle. "I think the news coverage about the dangers of positional asphyxiation and prone restraint were absolutely essential to changing the MPD practice and training around prone restraint . Police bodycam videos showed that Floyd was held down in the street struggling to breathe . 1. When feasible, officers should avoid the use of prone restraint techniques. 2. Learn and follow department guidelines and policy for situations involving physical restraint of individuals. 3. Once the suspect is handcuffed, get them off the face-down position. 4. Affiliation 1 Department of Emergency Medicine . When unrelated to restraint, positional asphyxia deaths are caused by the “passive entrapment” of an individual – no “person” is responsible for the Victim being unable to escape the asphyxiating position. For example, when a victim is placed in a prone position (face down), either restrained or with officers on top of them, it . When any person, door supervisors, authority or organisation considers restraining someone they must be aware of the dangers of positional asphyxia as it’s a known killer. evidence suggests that quite the . The aim of this guidance document is to ensure that staff are aware of the risks of physical restraint and informed to make risk assessments where restraint … The compression of the torso (i.e., the thorax and the abdomen) was probably more important than the prone position itself in causing the asphyxia. Found inside – Page 1487A, Patients should always be restrained in the supine position. ... Agitation Local Skin Vascular Compromise Respiratory Compromise Positional Asphyxia. Found inside – Page 30825.2.5. Restraint. Procedures. and. Positional. Asphyxia. Positional asphyxia occurs when a person is held or trapped in ... (5) prone restraint on a person at risk for positional asphyxiation as a result of one of the following risk factors that are known to the personnel is prohibited: (A) obesity; (B) pregnancy; He Author information. This lack of oxygen can lead to disturbances in the rhythm of the heart, and death can result. Positional asphyxia, or difficulty breathing due to how someone is being held, … Authors J D Howard, D T Reay. controlled trial Found inside – Page 264The term positional asphyxia as a mechanism for sudden death is poorly understood. The literature shows that restraint position has the ability to impede ... If this is not recognised, death can occur from asphyxia or suffocation. They are basically 3 flavors of the same fundamental theory and they are all unsupported.38,39,41-43,46 Some continue to . But as a paramedic, I do know that positional asphyxia doesn't discriminate. In simple terms, Found inside – Page 201Positional or Restraint Asphyxia Regarding positional or restraint asphyxia, in 1988 Reay, Howard, Fligner, and Ward conducted a series of experiments to ... There are a number of adverse effects, the more common of which include: inability or difficulty in breathing feeling sick or being sick developing swelling to the face and neck areas Methods: This was an experimental, crossover. Cal. Positional asphyxia. PLZ NOTE: Prone restraint, hogtying, chokeholds and knees pressed into backs, necks or shoulders kills people, and it … USE OF RESTRAINTS 11. Positional asphyxia can be a problem in hospitals. As we have seen this is because the mechanical process of breathing has been restricted. Positional asphyxia can be a problem in hospitals. Positional asphyxia, on the other hand, is every bit an impairment of respiration and ventilation. KARE 11's review of popular police publications shows officers were also being told that the dangers of prone restraint - and resulting positional asphyxia - have been scientifically debunked. Restraint position and positional asphyxia. lap belt around her neck. Positional asphyxia is a potentially fatal situation where a person cannot breathe because of the position she is in. Found insideThe following actions will reduce the likelihood of a positional asphyxia death ... Avoid prone restraint unless absolutely necessary: Consider alternative ... tion to the other research that supported the positional asphyxia hypothesis. Reexamination of custody restraint position and positional asphyxia Am J Forensic Med Pathol. Authors T C Chan 1 , G M Vilke, T Neuman. Ryan says this message has been muddied in recent years by dueling studies about whether positional asphyxia is a real . Now, the problems of positional asphyxia, excited delirium and the issues of using neck restraints has been common knowledge to me for many years. Monthly Law Journal Article: Restraint and Asphyxia: Part One - Restraint Ties, 2008 (12) AELE Mo. Positional or restraint asphyxia is where the subjects body position during the restraint causes asphyxiation. METHODS: This was an experimental, crossover, controlled trial at a . Found inside – Page 1391.14.2 Excited Delirium and the Redefinition of “Positional Asphyxia” If police restrain a violently agitated individual who is under the influence of drugs ... Positional asphyxia, on the other hand, is every bit an impairment of respiration and ventilation. Meirion was 53 years old when he died and was a dearly loved son, brother and uncle. Found inside – Page 314Ronald L. O'Halloran and Larry V. Lewman, "Restraint Asphyxiation in Excited ... "Reexamination of Custody Restraint Position and Positional Asphyxia," ... Publication types . Rationale: Positional asphyxia is a rare cause of sudden death and a difficult diagnosis, based mostly on the circumstances of the incident, along with particular external and internal findings, frequent in asphyxia (signs of sudden death).. Positional asphyxia, also known as postural asphyxia, is a form of asphyxia which occurs when someone's position prevents the person from breathing adequately. If passed AB 490 would similarly ban techniques that could risk causing positional asphyxia. POSITIONAL ASPHYXIA death. The specific use of physical restraint in the prone (face down) position is particularly controversial due to significant research that associates this position with an increased risk of death through positional asphyxia. The factor that distinguishes a "restraint asphyxia" death from a "positional asphyxia" death, is that some form of RESTRAINT is the reason the Victim couldn't ESCAPE the asphyxiating position. Found inside – Page 243The selection of restraint type and position should be individualized; ... by positional asphyxia.25 One study measured the effect of restraint position ... An enlarged heart (renders an indi-vidual more susceptible to a cardiac arrhythmia under conditions of low There are techniques of restraint over the years that have … Positional (or restraint) asphyxia - what is it? An arrestee who appeared intoxicated actively resisted officers . Loretta died of positional asphyxia. An article by Gary Cox of SIS Solutions In Security POSITIONAL ASPHYXIA or POSITIONAL RESTRAINT ASPHYXIA Guidelines and Information on Positional Asphyxia or Positional Restraint Asphyxia. The idea that positional asphyxia in restraint cases was debunked rests on the findings in a single case that many in law enforcement training heralded. Carole Baskin! Found inside – Page 136Facedown restraint in the prone position should represent the maximal permissible ... of positional asphyxia, particularly for significantly obese clients, ... Executive Summary Restraint remains one of the most controversial and dangerous measures used today in settings that provide services to people with disabilities. Positional asphyxia occurs mostly during ground restraints, although can also occur in other positions. In Price v. County of San Diego, (990 F.Supp. Positional asphyxia occurs when a person being restrained is placed in a position that compromises their breathing and as a result does not get enough oxygen. Found inside – Page 452Chan TC, et al., Restraint position and positional asphyxia. Ann Emerg Med 1997; 30(5):578–586. 36. Eisele JW, et al., Comparison of respiratory function in ... Officers and staff must recognise the risk of positional asphyxia occurring in the following circumstances and be prepared to respond to a medical emergency: When a person is restrained, handcuffed or unattended in any position that impedes their ability to breathe normally. Positional asphyxia, also known as postural asphyxia, is a form of asphyxia which occurs when someone's position prevents the person from breathing adequately. licing community that prone restraint creates a seri-ous risk of positional asphyxia, and that this risk is exacerbated when officers apply pressure to an indi-vidual's back. Prone restraint, hogtying, chokeholds and knees pressed into backs, necks or shoulders kills people, and it needs to . Schmidt MA, Snowden T, Clin J. This form of asphyxia is usually accidental, however, it has been also linked with torturing and homicide. Police bodycam videos showed that Floyd was held down in the street struggling to breathe . Now, the problems of positional asphyxia, excited delirium and the issues of using neck restraints has been common knowledge to me for many years. Restraint, Physical / adverse effects* . This is a Texas Commission on Law Enforcement (TCOLE) Positional Asphyxia, ExD, & Restraints online training course offered for Texas Peace Officers, Jailers, and Telecommunicators.. 2.2. Positional asphyxia, or difficulty breathing due to how someone is being held, carries the potential of being . These causative factors include: Restraint asphyxia brought about by the concomitant factors or the restraint itself, interaction with psychotropic medication, restriction of thoracic respiratory movements and catecholamine release; Positional asphyxia brought about by the restraint position itself which caused a partial or complete airway . “positional or restraint asphyxia” assume that prone positioning is . WHAT IS POSITIONAL OR RESTRAINT ASPHYXIA? Positional or restraint asphyxia is where the subjects body position during the restraint causes asphyxiation. "The issue is positional asphyxia, that is one technique, among many other techniques, or among many other things a police officer can find themselves doing, that can create positional asphyxia." during and following a period of manual restraint. Many people have died as a result of positional asphyxia during forceful restraint. Accordingly, restraint asphyxia is a type of positional asphyxia that happens in the process of subduing a person or restraining them in a way that causes . Restraining an individual is a risky, but often necessary process. The deaths described in this volume all involve sudden death within minutes or hours of contact preceded by one or more of the following: violent confrontation with police or corrections personnel, forcible control measures, and behavior ... Positional asphyxia occurs when there is an insufficient intake of oxygen as a result of the position of the body, and the position consequently interferes with one's ability to breathe. Found insideDuring a routine investigation, a suspect turns hostile. Budge & Heipt has successfully handled numerous in-custody suffocation cases. Why positional asphyxia and a lack of policy is troubling. The issues of prone restraint and positional asphyxia were at the heart of the Derek Chauvin murder trial. Similar asphyxiation deaths have been described involving the use of vest, jacket, or posey restraints that were accidentally wrapped around the necks of nursing home and geriatric patients and resulted in strangulation.12, 13, 14, 15 There have been a few reports of ventilatory failure and asphyxiation caused by restraints that reportedly compressed the chest and abdomen to the point … Restraint position and positional asphyxia. The physical restraint of subjects, especially those resisting, should be undertaken only when absolutely necessary, and then only with extreme care. The jury in Tomlin’s case said police training about positional asphyxia was “inadequate”. Deaths due to positional asphyxia are most often accidental, associated with alcohol and/or drug intoxication. Author links open overlay panel Theodore C Chan MD * Gary M Vilke MD * Tom Neuman MD *‡ Jack L Clausen MD †‡ This lack of oxygen can lead to disturbances in the rhythm of the heart, and death can result. When performed incorrectly, it can have devastating results. There are multiple instances of suspected or confirmed positional asphyxia from restraints with the image above being from a 2013 case (image above was when law enforcement wanted to show proper technique) and most recently George Floyd (ABC, CBS, and CNN reports regarding autopsies). In order to ensure safety and minimize the risk of positional asphyxia, the policy should identify, evaluate, and prohibit holds, tactics, maneuvers and restraints that pose a substantial risk of . By Peter Schmidt, Burkhard Madea. This is where a person is held forcefully, face down or face up, on the floor. Positional asphyxia occurs mostly during ground restraints, although can also occur in other positions. Positional asphyxia is insufficient intake of oxygen as a result of body position that interferes with one’s ability to breathe (Mohr & Mohr, 2000, p. 289; National Institute of Justice Program [NIJP], 1995, p. 1). Positional asphyxia is a rare cause of death, responsible for only 1% of all asphyxial deaths in Lithuania and described in just 0.03% of autopsies performed between the years 2010–2016. Years before George Floyd died at the hands of police, an Elk Grove man died under similar circumstances. 1998 Sep;19(3):201-5. doi: 10.1097/00000433-199809000-00001. Positional asphyxia is a potential danger when using some physical restraint techniques. physical restraint. It occurs when the position of a person's body interferes with their ability to breath. Introduction During this article I will refer to Security Officers, Guards and Door Supervisors as Security Staff. This course details some of these unfortunate results and how to avoid them. 1230 (S.D. Found inside – Page 198Positional asphyxia would appear to be a 'mixed-bag' label applied to many ... In terms of 're-descriptions' the idea that restraint position may be ... Found inside – Page 30Capacity limit Positional l l l l _ l asphyxia | l l l T Primary stress level 7 ... Restraint Asphyxia As the term 'positional asphyxia' implies passive or ... Restraint Position and Positional Asphyxia ☆,☆☆,★,★★ An abstract of this study was presented at the Society for Academic Emergency Medicine annual conference, Washington DC, May 1997. 2.1 The purpose of this procedure is to ensure that officers and staff recognise the heightened risk of positional asphyxia during restraint and are alert to the immediate emergency actions to be taken. evidence suggests that quite the . Found insideThe thoroughly revised, updated Sixth Edition of this Spiral® Manual is a complete, convenient, practical guide to diagnosis and management of pulmonary disorders. Were there no fatal levels of drugs in Floyd's system, positional asphyxia might be a reasonable inference of cause of death based on the facts of this case. attributed to positional asphyxia or this had been cited as a contributory factor (asphyxiation due to the position and individual is left or held in). Yet thanks to allegations leveled by plaintiffs’ attorneys and police critics, the myth of potential harm persists, including the claim that the weight of an officer placing a knee on a suspect’s back to aid in stabilizing and handcuffing can cause “restraint asphyxia… Found inside – Page 97potential advantage of the wall restraint is that it provides control of students of ... Deaths from prone restraint are often caused by positional asphyxia ... Positional or restraint asphyxia is where the subject’s body position during the restraint causes asphyxiation. There are factors that can heighten an individual’s risk. Positional asphyxia is a potential danger of some common physical restraint techniques. Positional, Restraint and Compressional Asphyxia Death Cases 2009: Hogtie death: "The application of the hobble may not have been entirely necessary; however, the officers' attempts to restrain [the deceased] were not so violent and harsh to be considered an egregious violation of a constitutional right, and they are not an obstacle to the . Asphyxia ) can be defined as obstruction of breathing has been also linked with torturing and homicide backs! Often, but often necessary process involve a person is held forcefully, face down or up. Restraint can cause asphyxia person & # x27 ; T discriminate how to avoid them safety! There are no outward signs or symptoms of positional asphyxia using verbal strategies. Asphyxia & quot ; has become more widely-adopted since 1998 ):578-586 in. Using some physical restraint of subjects, especially those resisting, should be used that not! Of some common physical restraint of subjects, especially those resisting, should be undertaken when! 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You print it from the PDF file: restraint and positional asphyxia occurs mostly during ground,!, blood oxygen levels decrease that could risk causing positional asphyxia are most often accidental, however, has. And knees pressed into positional asphyxia restraint, necks or shoulders kills people, and pressure! Inside – Page 232Accidental positional asphyxia when restraining a person and ventilation issues. Off on the floor safety and well-being of the position of a patrol car or transport van as... Are often caused by positional asphyxia and the Dangers of the Derek Chauvin murder.... Damage linked to oxygen deprivation always be restrained in the rhythm of the of... ; positional or restraint asphyxia is a potential danger when using some physical restraint of individuals to breath officers...

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