[View this article with photos on PoliceOne.com]
A technique for “working smarter rather than harder” to restrain unusually strong, combative subjects was described by an advisor to the Force Science Research Center at a recent international conference on in-custody deaths that featured presentations by nearly 20 of the world’s leading authorities on excited delirium (ED).
The technique, which requires a coordinated effort by several officers, involves “humanely misaligning” a struggling suspect’s muscles and joints to control his movements and reduce his capability of resisting while restraint devices are applied, explains Chris Lawrence, who outlined the tactic at the 2nd annual symposium of the Institute for the Prevention of In-Custody Deaths last month [11/07] in Las Vegas.
“A resisting subject can generate significant power with his arms, legs, and shoulders,” Lawrence says. “If you take these out of their natural power alignment, the individual can be controlled with less effort and with greater safety.”
Initially conceived as a response tool for ED confrontations, the procedure can be used effectively in managing a wide variety of strong, combative subjects, from drunks to the violently enraged and drug-fueled, says Lawrence, a prominent Canadian defensive tactics trainer and a technical advisor to FSRC at Minnesota State University-Mankato.
The technique was devised, tested, and refined by a cadre of Canadian police trainers led by Lawrence, in consultation with street officers, DT instructors, and ED medical experts scattered through North America. Lawrence, a columnist for FSRC’s strategic partner PoliceOne.com, has researched and reported on ED developments to LE audiences for about 9 years.
BENEFITS. “Often when officers try to control a resistant person who’s exerting tremendous strength, as in excited delirium, they end up trying to out-muscle him,” Lawrence told Force Science News. “This requires significant exertion, and unless the officers’ efforts are greater than the suspect’s, they won’t prevail. Even if they succeed, there’s a risk of injury to the officers, the subject, sometimes even to innocent bystanders.
“Rather than work harder, the suggestion is to work smarter,” with the coordinated application of leverage and body mechanics. With this method, which Lawrence informally calls the Canadian Response, “even officers whose size and strength can’t begin to match that of the suspect should still quickly prevail, with a greater margin of safety for everyone involved.”
In training sessions, Lawrence selects “the biggest guy in the class” to role-play the subject and “5 other big people” to try to control him. The officers are told to “use any technique you want to get the subject into a prone, controlled position,” while the subject is instructed to “do anything you want to get out.”
Typically, Lawrence claims, “within 4 to 5 seconds, the subject has been able to rise up at least to his hands and knees.”
After instruction in the Canadian Response, 5 of the smallest people in class take on the biggest one. “I stand there ordering him to get up, but he can’t. The usual reaction is, ‘I can’t believe this.’”
“The Canadian Response shares the key component of all good physical control techniques,” notes FSRC’s executive director, Dr. Bill Lewinski. “It allows officers to maximize their biomechanical advantages and diminishes the biomechanical advantages of the subject. When done well, it should literally rob the subject of his power, regardless of his size, strength, and physical and emotional intensity.”
Maximizing speed and minimizing exertion in achieving effective restraint is especially important when dealing with ED subjects who are not compliant with verbal persuasion, Lawrence explains.
“There’s nothing a police officer with a first-aid certificate can do to help the subject at the side of the road. Experts agree that getting these people to a medical facility as promptly as possible without unnecessarily intensifying their agitated, overstressed state with a prolonged struggle appears to increase their chances of surviving what can be a fatal episode. Unless they are physically controlled, however, ambulance crews won’t transport them, so restraint, when necessary, becomes imperative as a first step in receiving medical care.”
GROUND POSITIONING. The Canadian Response works best with 4-5 officers concentrating on a subject who’s on the ground, front side down. (Lawrence does not specifically address how he gets there, but the presumption is that he’s tackled, Tasered, tripped, or otherwise brought down and maneuvered to a prone position; pain compliance will not reliably do the job because the subject may well be impervious to pain.)
“The ground provides a consistent , reliable platform that works to the officers’ mechanical advantage,” Lawrence says, “and getting the subject proned out actually results in lesser force being necessary than if he were on his back. So long as the subject is face down, you’re in less danger from his natural weapons,” his limbs.
ARM CONTROL. Experimentation showed that even highly muscled individuals display the least strength in weight-lifting when their arms are straight out at their sides, Lawrence says, so this is the position the first 2 officers want to get the proned subject’s arms into-extended out at an angle of 90 degrees or slightly higher from the ribcage.
If the officers sit facing away from the subject, they can each grab an arm, fully extend it, clamp it with the crook of their elbow, and lock it in against their side and across their thigh-a seated variation of the arm-bar maneuver. With one hand controlling the subject’s wrist, they turn his palm up, then use their upper-body weight to lean against and apply pressure to the back of his deltoid (shoulder) muscle, pushing toward the ground.
“This pins him, without causing injury,” Lawrence says. “By keeping his arms locked out and anchored, his wrists turned and off the ground, and his shoulders down, you misalign his muscles and joints. His arms are less effective in offering resistance, but his ability to breathe remains uncompromised.”
In some cases, Lawrence points out, subjects may go prone with their arms tucked under them, hands clasped tight against their chest-what Lawrence calls a powerful “turtle position.” To avoid a strenuous struggle to gets the arms free, you are often best off to use a baton as a leverage tool and pry them out.
LEG CONTROL. The next 2 officers secure the subject’s legs. “Again, the principle is misalignment of the muscles to reduce the subject’s ability to generate power,” Lawrence says.
These officers each capture a foot and get on the ground between the subject’s legs to move the heels as far apart as possible. Pushing against each other back-to-back can help gain leverage in parting and extending the legs.
Continuing to face away from each other, each officer then wraps his/her body around an ankle, turning the toes out and bringing his/her weight to bear against the end of the long leg bones to hold the limbs down securely.
“This positioning substantially reduces the subject’s ability to raise his legs and exert himself with the most powerful parts of his body,” Lawrence says.
5th OFFICER. If an additional officer is present, he or she can be plugged in where needed most.
If more control is necessary, this officer, kneeling at the subject’s head, can apply pressure through his/her hands to the subject’s shoulders, roughly where the rotator cuffs are (not on the spine). “This tends to be more effective than holding the subject’s head,” Lawrence explains, “because a head hold leaves more possibility for the subject to torque his shoulders, move his upper trunk substantially, and try to get up or buck to a more powerful position.”
If the subject seems well-controlled, the 5th officer “can also work as a quarterback, overseeing the process and scanning for threats.” Or he/she can move in to begin the handcuffing process.
HANDCUFFING. The Canadian Response involves the use of multiple pairs of handcuffs, not only for easier initial application but also because this allows the subject to be transported by ambulance in a more desirable position for monitoring.
If an extra officer is not available, the arm-control officers must handle the cuffing on their own. If they have trouble reaching their cuffs, a leg officer may be able to hand up a set to get the process started. “This is very flexible,” Lawrence says.
One arm-control officer goes first, transitioning from the pin position by raising the subject’s wrist high, turning the arm, and bending the elbow so the arm folds behind the subject’s back in a cuffing position. The officer turns to face the subject’s spine as he/she brings the arm around. The subject’s upper arm is held firmly between the officer’s knees, one of which is placed over the subject’s scapula, the other on the ground. Once a cuff is on that wrist, the other officer repeats the process with the other arm.
Now the unused portions of the 2 handcuff sets can be hooked together. Or, with large subjects, they can be connected to a third set of cuffs interposed between them. “The idea is to create enough separation between the subject’s hands that he can lie flat, without riding on his cuffed wrists, once he is turned over on his back for ambulance transport,” Lawrence says.
He warns, however, that a subject who must be transported by patrol car rather than by ambulance should not be handcuffed with extended space between his wrists.
Important: The subject should not be turned onto his back until his legs are firmly restrained.
LEG RESTRAINT. Once the subject is handcuffed, his legs are then brought together, under control, and are securely strapped together. Once the strap is cinched snug, the loose end can be stood on to keep the subject from moving his legs. Note: This is a hobble restraint, not hog-tying.
TRANSPORT. After the legs are strapped, the subject can be rolled to his side. When he’s transferred to a gurney for transport to a medical facility, the strap can be tied to the end of the stretcher to keep the subject from raising or thrashing his legs. EMS personnel will apply additional restraints of their own, but at least one officer should still ride in the ambulance for added security.
“With the daisy chain of handcuffs, the subject should be able to lie on his back with his hands beside his hips so that the paramedics or EMTs can better monitor him,” Lawrence says. “With him supine [face up], they’re better able to watch his breathing, use a stethoscope to check his heart, apply a blood pressure cuff, start an IV, and so on.
“The usual gurney strapping will prevent him from sliding the cuffs below his butt and attempting escape.”
Lawrence cautions that use of this control procedure is by no means an iron-clad guarantee against injury to officers or subjects. Nor can it assure that a subject beset by ED won’t still die suddenly and unexpectedly, despite the best efforts of police and medical personnel. “There is still a great deal that’s unknown about this complicated phenomenon,” he says, “including exactly why the ED experience culminates in death for some of these subjects. Plus, no tactic is guaranteed to work on a particular subject, and every control technique has some element of risk.
“But based on what we know so far, the Canadian Response seems to provide hope for safely handing an afflicted subject off to medical personnel. It requires no new equipment for officers to buy or to carry on their belts or in their car, and it incorporates the kind of simple DT movements that they are already familiar with.”
Obviously, performing smoothly as a team requires practice. “But officers who’ve trained in the technique are amazed at how successful it can be,” Lawrence says.
He plans to demonstrate the technique at the ILEETA (International Law Enforcement Educators and Trainers Assn.) 2008 training conference, Apr. 1-5 in Wheeling, IL, a suburb of Chicago.
Lawrence can be reached at firstname.lastname@example.org.
[For previous articles on challenges and recommendations related to controlling ED subjects, search the Force Science News archives at www.forcesciencenews.com. Our thanks to PoliceOne trainer Gary Klugiewicz, a member of FSRC’s national advisory board, for tipping us to Lawrence’s Las Vegas presentation.]