Cardiorespiratory Consequences of the Hobble Restraint

Roeggla, Georg; Roeggla, Hannelore; Moser, Berthold; Roeggla, Martin; Hick, John L.; Smith, Stephen W.; Lynch, M.

doi:10.1111/j.1553-2712.1999.tb01201.x

Cited by 24 publications

(56 citation statements)

References 12 publications

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“…Since spirometry measures were the variable that showed the most dramatic and consistent reduction as a consequence of restraint, we calculated where possible the effect size (ES) and 95% confidence intervals. The percentage reductions given above and the ES calculations of 23.1, 20.8, 20.5 and 21.5 for FVC and 23.9, 21.2, 20.7 and 21.5 8,9,13,16 for FEV1, respectively, and tidal volume ES of 20.4 11 shows the restraint positions investigated can be expected to reduce lung volumes.…”

Section: Resultsmentioning

confidence: 94%

A review of the scientific literature related to the adverse impact of physical restraint: gaining a clearer understanding of the physiological factors involved in cases of restraint-related death

2012

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Deaths occurring during and/or in close proximity to physical restraint have been attributed to positional asphyxia, a conclusion primarily based on opinion and reviews of case studies. This review sought to identify the current scientific evidence available in regard to the aetiology of adverse events or death occurring during or in close proximity to physical restraint. A systematic search of electronic databases (SPORTDiscus, AMED, CINAHL, MEDLINE, PsycINFO) for papers published in English, between 1980 and 2011, using keywords that related to restraint, restraint position and cardiovascular function resulted in 11 experimental papers being found for review. The term positional asphyxia as a mechanism for sudden death is poorly understood. The literature shows that restraint position has the ability to impede life-maintaining physiological functions, but that the imposed impediment is not uniform across all restraint positions/techniques. Further research is required to ascertain the risks posed by struggling during restraint for more prolonged periods of time and in different positions using varied techniques of restraint. This research should seek to and rank known or future risk factors of adverse events occurring during restraint, seeking to understand the interactions and if present the cumulative effect of these risk factors. Finally, future research should focus on populations other than apparently healthy male adults.

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Section: Resultsmentioning

confidence: 94%

A review of the scientific literature related to the adverse impact of physical restraint: gaining a clearer understanding of the physiological factors involved in cases of restraint-related death

2012

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“…The rise in inthrathoracic pressure causing an impairment of venous return is likely to be the main pathogenetic mechanism, and the decrease in heart rate can be explained by the activation of the Bezold-Jarisch reflex 3. Similar changes have been observed in restrained agitated patients where sudden death has occurred 4 5. A possible explanation for the difference between our findings in suspension and sit harnesses compared with those of Lee and Porter could be the short time of suspension used in our experiment.…”

mentioning

confidence: 74%

Suspension trauma

Röggla

Moser

Röggla

2008

Emergency Medicine Journal

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“…Whenever death in previously asymptomatic carriers of a peculiarity, such as accessory bundles, but including others, is precipitated through dehydration [25], changes in diet [20], exercise [26], restraint [27], hypokalemia [28], catecholamines [29], or emotional stress [30], legal categorization of the death can be controversial [31]. In this instance, absence of perceptible dehydration led to the conclusion of natural death as a consequence of WPW syndrome.…”

Section: Discussionmentioning

confidence: 98%

Digital 3D reconstruction of two parahissian accessory bundles in a case of Wolff-Parkinson-White syndrome

Steffen

Schaepman

Hardmeier³

et al. 2004

International Journal of Legal Medicine

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Three-dimensional reconstruction of digitized histological serial sections of the cardiac conduction system yielded two accessory pathways in a case of a 24-day-old male infant who died after a short period of illness with ECG findings of Wolff-Parkinson-White syndrome. In infants, the differential diagnosis of possible accessory pathways connecting the AV conduction system, atrial or ventricular septum includes dispersed conduction system tissue without connecting features. This is why three-dimensional reconstruction is necessary in order to refute or establish connectivity of cell groups as found in histological serial slice images.

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Cardiorespiratory Consequences of the Hobble Restraint

Cited by 24 publications

References 12 publications

A review of the scientific literature related to the adverse impact of physical restraint: gaining a clearer understanding of the physiological factors involved in cases of restraint-related death

A review of the scientific literature related to the adverse impact of physical restraint: gaining a clearer understanding of the physiological factors involved in cases of restraint-related death

Suspension trauma

Digital 3D reconstruction of two parahissian accessory bundles in a case of Wolff-Parkinson-White syndrome

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