Stratton et al identified risk factors for sudden death in persons being held in a hobble restraint for excited delirium. The authors are from Los Angeles, California.
Person at risk: extremely agitated and/or in excited delirium
Type of restraint: hobble restraint (with all 4 extremities secured behind the back, also referred to as the total appendage restraint procedure or hog-tying.)
Risk factors:
(1) forceful struggle against restraints
(2) current stimulant drug use
(3) underlying comorbid condition(s), such as coronary artery disease, cardiomyopathy, seizure disorder, etc.
(4) obesity, with BMI > 29 kg per square meter
If the person (1) who has been struggling suddenly stops struggling and/or (2) shows shallow or labored breathing, then cardiopulmonary arrest is imminent.
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