This page is STILL under CONSTRUCTION!
Until this "blurb" is REMOVED, this page remains a "rough draft" version, and its contents should NOT NECESSARILY be implemented as currently written. However! Protocol-writers with a strong understanding of the information contained within the articles, "All Tied Up & No Place To Go" and "Restraint Asphyxia – Silent Killer," should be able to use this "ROUGH" information to build their own protocol. If you have "time" to delay your protocol writing, PLZ check back here periodically, to see if MY version of this protocol has been completed!

The following text was just "plugged in here" from an OLD VERSION of Restraint Asphyxia – Silent Killer, Part Three!

(1) Upon arrival, if the patient is restrained in a prone position (hobbled or not), IMMEDIATELY roll the patient OFF of his stomach!!!

(2A) Once on his side, if the patient is UNCONSCIOUS and in hobble restraints, remove the hobble (the tie that binds the wrists to the ankles) and the handcuffs, and assess for respiratory or cardiopulmonary arrest.
If Rescue Breathing is indicated, implement it (!) while others are removing ALL restraint devices.
While providing appropriate resuscitation measures, have the patient restrained SUPINELY to a LBB. If you are fast enough (if the respiratory arrest patient hasn't entered cardiac arrest), the patient will rapidly regain consciousness, and WILL return to a combative state!

[The following steps outline the manner that the patient should be supinely restrained to a long back board. However, from here on, we will assume that the restrained patient was NOT unconscious upon your arrival.]

(2B) If the side-positioned, restrained patient is CONSCIOUS (still combative, OR NOT),
law enforcement restraints (handcuffs, ankle shackles – even hobble restraint)
may REMAIN IN PLACE as long as the patient is maintained on his SIDE!

(3) Keep the restrained, conscious, patient on his side until a "sufficient number of people" are available to control the patient during alternative restraint replacement.
At least FIVE PEOPLE are required to accomplish the safe transfer of significantly violent individuals from law enforcement restraint to MEDICAL restraint: one person to control each limb/major joint, and one person to apply alternative restraints.
Additionally, someone needs to be identified as the "Team Leader." The Team Leader is the person "calling the shots," and should be the person who knows how to safely accomplish the restraint transfer! ("Team Leader" assignment should NEVER be based upon "rank!")
All assisting persons need to know what their "assigned limbs" are – and what the "plan" is – before any action is actually implemented.

NOW, REFER TO THE "Violently Confused or Combative Patient Restraint Protocol"

APPROPRIATE, SAFE & EFFECTIVE, RESTRAINT PROTOCOLS:

• 1) Introduction to Patient Restraint Universal Reasons For,
  and Basic Principles Regarding, SAFE Patient Restraint

• 2) Restraint Protocol for EVERY Unconscious Patient

• 3) Resistively Confused Patient Restraint Protocol

• 4) Violently Confused or Combative Patient Restraint Protocol

• 6) Spinal Immobilization Protocol for the
  Violently Confused or Combative Trauma Patient

• 7) Documentation Guidelines for Every Restraint Application

• "Quick Look" On-Scene Restraint Reference Card

Email Charly at: c-d-miller@neb.rr.com
Those are hyphens/dashes between the "c" and "d" and "miller"