Caution: Hold-Down Techniques Can Be Fatal
by Jim Wagner

Do you carry a pair of handcuffs? Most martial artists don’t. How, then, are you supposed to restrain that criminal you just overpowered until the police arrive?

You probably won’t be able to take off your belt or shoestrings to create an improvised restraining device, especially if the suspect is struggling. Instead, you’ll most likely do what other people would do in the same situation: force him to the ground and hold him there. If you have friends nearby and they decide to help, it can end up becoming a dog pile.

Then the suspect screams: “Get off! I can’t breathe!” But you’re not going to fall for that old trick, are you? A few minutes later, he dies. Regardless of what crime he may have committed, the police will arrest you for manslaughter even though you were initially the victim or simply a good Samaritan.

His death resulted from a phenomenon called restraint positional asphyxiation. It can occur whenever someone who doesn’t have proper training in submission holds and arrest-and-control techniques tries to hold someone down.

Most police officers and military peacekeepers know the dangers of positional asphyxiation. I first learned about it in 1999, when the law-enforcement community started to seriously address in-custody deaths. I’ve taught it in my Reality-Based Ground Survival course for civilian martial artists since 2003.

Positional asphyxiation occurs when a person’s body position interferes with his breathing or when the application of an external force prevents him from getting enough oxygen. Most suspects are placed facedown on the ground to force them to submit or prevent them from escaping. The person using the controlling force will usually place a knee on the subject’s back, or sit or lie on him to make him comply with his orders. However, the weight compresses the chest and limits the suspect’s ability to expand his chest cavity. The pressure may also push up his abdominal organs, restricting the movement of his diaphragm and further limiting the space in which his lungs can expand.

Primary risk factors for positional asphyxiation include prolonged physical exertion, a respiratory condition like asthma or bronchitis, heart disease and obesity. An irrational, overly aggressive or psychotic person is also at increased risk because of a condition known as “excited delirium.” Some drugs, especially cocaine, can cause acute excited delirium. Under the right circumstances, the person can die within minutes.

If you ever find yourself in a self-defense situation in which you must hold down a suspect, be aware of the warning signs for positional asphyxiation:
 * He requests medical attention or states he can’t breathe.
 * He starts hyperventilating.
 * He loses consciousness.
 * He stops breathing.

Once you have him under control, you must take steps to keep him from suffocating. If you happen to be part of a group holding someone down, be the voice of reason. Ask your cohorts, “Do you want to be responsible for this guy’s death?” Mentioning death can make people more responsive when the adrenaline is flowing.

If the subject is in distress, have him lie on his side or sit up as long as you can properly restrain his hands. Note that prisoners have died while lying facedown with their hands tied to their feet—with nobody on top of them. It’s the prone position that’s dangerous, not just the applied pressure or weight.

To help students appreciate the risks of positional asphyxiation, you can simulate a series of citizen’s arrests in which they role-play the suspects and instructors play the defenders. Have them start by sparring a round or two to induce heavy breathing, then tell the suspects to lie facedown while one or two defenders put some weight on each person’s back for a few seconds. Then have the defenders roll the suspects on their sides so they can feel the pressure release.
Including positional asphyxiation awareness in your school’s training—always with close supervision—may not only save a life, but also keep you and your students out of legal trouble.

About the author: Jim Wagner is a police and military defensive-tactics instructor and a civilian reality-based personal-protection trainer. For more information, visit http://www.jimwagnertraining.com.