REVIEW ARTICLE CITATION:
Chan TC, Clausen J, Neuman T, Eisele JW, Vilke GM.
Does weight force during physical restraint cause respiratory compromise?
Ann Emerg Med, October 2003;42(4),
ACEP Research Forum Supplement: pS17.
CHAS' 2003 REVIEW CITATION:
Miller CD. Chas' review of Does weight force during physical restraint cause
respiratory compromise? October 2003;
http://www.charlydmiller.com/LIB05/2003chanweightreview.html
Consider INSTEAD Reading CHAS' NEW (2005)
Opinion Paper related to this article!:
"A Comprehensive Review of Frequently Misinterpreted
and Misrepresented Restraint Research" PART THREE
Besides being "kinder," the 2005 paper is a much more
IN-DEPTH review of this study abstract.
The most interesting content change between Chan's 2003 version of the original study-findings' 2000 abstract (when Dr. Eisele was "lead" – first-listed – author of the same study's abstract):
Chan entirely neglects to mention how perfectly healthy the study's subjects were. In Dr. Eisele's abstract, he clearly identified the study-subjects as being "healthy volunteers" who, when specifically screened, demonstrated perfectly wonderful pulmonary function. At screening, if any study-subject volunteer demonstrated a "baseline forced vital capacity (FVC) or forced expiratory volume in one second (FEV1) outside of acceptable limits," the volunteer was "rejected" and prevented from participating in the study.
Why did Chan so blatantly neglect to identify that this study only explored the effect of weighted-prone-restraint upon healthy persons? I have no idea. Maybe it was to somehow help him continue his apparent crusade to promote forceful-prone-restraint application, and to kill more altered-level-of-consciousness victims.
Another interesting alteration: Chan's 2003 abstract entirely fails to include the following significant information contained within Eisele's 2000 abstract.
Although body size and habitus* are matters of concern in evaluating the effects of restraint, the subjects in this study were intentionally kept within an average range; because of the small number of subjects it was felt that including extremes of body size would decrease the statistical significance of the results. Likewise, the amount of weight in this study was limited, but the authors lack of specific knowledge of the effects of this procedure made this a matter of safety for the volunteers. These are clearly matters of concern for future studies.
* Since I had to look it up to be sure I understood its use;
here is the 17th ed. of Taber's Medical Dictionary's definition of habitus =
1. A physical appearance, body build, or attitude.
2. A physical appearance that indicates a tendency for a person to develop a specific disease.
However, as used in this context, it seems clear that the abstract authors' use of the term, "habitus," primarily refers the WEIGHT of someone's body.The Primary "Problems" With This Study Remain Exactly The Same
As When Its Findings Were Presented In 2000:
- Studying the effects of restraint upon healthy individuals does not – at all – further the understanding of what happens when medical or traumatic altered-levels-of-consciousness-victims are restrained.
- The weights employed by this study were significantly LESS than the weights employed during real-life field-application of restraint to medical or traumatic altered-levels-of-consciousness-victims who require restraint. (How many 50- to 100-pound police officers, firefighters, or EMS providers have YOU ever seen? And, how many of THEM restrain incredibly combative persons all by themselves?!)
(Read CHAS' Review of the 2000 Abstract if you want more information about this point.)
- When subjected to ludicrously-light weight while prone-restrained, this study's results clearly demonstrated that healthy individuals DID experience "a decrease in spirometry parameters" ... or, as Chan puts it, "decrements in FVC and FEV1 consistent with a restrictive pulmonary function pattern." Yet, Chan's version of the study's conclusions ends by identifying that the study "did not result in evidence of hypoxia or hypercapnia." Whereas, Eisele's version ends with, "These are clearly matters of concern for future studies."
ESSENTIALLY:
The restraint position studies performed by Chan et al have done little-to-nothing to help understand restraint asphyxia deaths. Indeed, as I've already indicated, Chan et all consistently demonstrate a twisted interest in promoting the continued application of forceful-prone-restraint, thus promoting the deaths of altered-level-of-consciousness victims at the hands of those charged with their emergency care.
* I swear that I'll soon publish the documents I have (case reports and deposition transcripts), demonstrating Chan et al's heinous misrepresentations of their study findings! It's just taking me a while to get to it![HELLO! That stuff is NOW published in
"A Comprehensive Review of Frequently Misinterpreted
and Misrepresented Restraint Research"]In the words of Dr. Ronald L. O'Halloran, a renown restraint asphyxia forensic specialist;
"Few rational pathologists would deny that people can die with enough weight compressing their chest. ... In the case of prone restraint with weight applied to the back, the question isn't really whether a person could die from asphyxia; sufficient weight applied to the back for a sufficient time will kill the healthiest of individuals. ... If those who doubt the asphyxial potential of prone restraint with weight on the back would lie prone on the floor, hold their ankles behind their back, and have a trusted friend sit on their back for a minute while they try to breathe, most doubts would vanish."(1)What a concept! But, have Chan et al done this? If they have, they are guilty of conspiring to promote the death of every restraint asphyxia victim since they did so.
YOURS, CHAS
REVIEW REFERENCE:
(1) Letter to the Editor RE: Asphyxial Death During Prone Restraint Revisited
& the Article Authors' Reply Am J Forensic Med Pathol 2000;21(4):420-422.
Read CHAS' NEW (2005) Opinion Paper related to this article!:
"A Comprehensive Review of Frequently Misinterpreted
and Misrepresented Restraint Research" PART THREE
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