What is Positional Asphyxia in Security?

What is positional asphyxia in security and why is it dangerous?

In UK security settings, positional asphyxia occurs when someone's body position during restraint prevents them from breathing properly. This can happen if the person's chest, neck or abdomen is compressed, or if their airway is obstructed due to the way they are being held. When airflow is restricted and breathing becomes shallow or stops entirely, oxygen levels drop rapidly. If action is not taken straight away, this can lead to unconsciousness and potentially death. Situations involving restraint are often tense and physically demanding, which makes it even more important to use methods that prioritise safety and breathing.

Understanding the risks and causes of positional asphyxia

Which restraint methods increase the risk of positional asphyxia?

Some physical control techniques increase the chance of respiratory restriction. Restraining someone in a face down position, known as prone restraint, carries significant risk. In this position, the weight of the individual combined with added pressure from security staff or equipment can make it difficult for the chest to rise. Breathing becomes harder, and the diaphragm struggles to work properly. Even short periods in this position can be dangerous.

What factors make someone more vulnerable to breathing restriction during restraint?

Obesity and body composition

People with a higher body mass index are more likely to experience difficulty breathing when placed in restrictive positions. Excess weight can press on the chest and abdomen, especially when the person is lying on their front. This makes it harder to draw in air and sustain oxygen levels.

Drug and alcohol effects

Substance use affects how the body functions during restraint. Alcohol and drugs can slow down breathing or increase agitation, leading to more resistance. As the struggle becomes more intense, so does the risk of exhaustion and asphyxiation. Security officers need to take extra care when dealing with intoxicated individuals.

Existing medical conditions

Chronic respiratory or cardiovascular issues make people more likely to suffer complications when restrained. Conditions like asthma, heart disease and diabetes can reduce the body’s ability to cope with physical strain or low oxygen. Any restraint should be adjusted if the person has known health conditions.

Emotional stress and panic

Someone who is extremely anxious or panicked may already have rapid or shallow breathing before any restraint begins. If physical restraint is added without consideration for their breathing state, oxygen levels can fall faster. Situations involving mental health distress should be managed with extra sensitivity and observation.

How do procedural gaps affect the risk of positional asphyxia?

Risks increase when restraint is not properly supervised or when staff are unaware of best practice. If someone is restrained and then left in a harmful position without checks, the chances of harm increase. These risks can be reduced through clear procedures and regular training.

Security teams must also monitor the individual continuously during and after restraint, especially if the person has been in a prone or physically restrictive posture. If signs of difficulty are missed, the outcome can be serious.

Internal training should reference current guidance from sources like the College of Policing and NHS Positive and Safe programme. Regular refreshers help staff retain knowledge about how to recognise and respond to signs of distress.

See related best practice guidance on physical restraint from the College of Policing

Preventing positional asphyxia in professional security practice

What safer alternatives to prone restraint should be used?

Security professionals can reduce risk by using safer alternatives to prone restraint. These include seated holds or side-lying positions which reduce the pressure on the chest and allow better visibility of the person's face and breathing. If restraint is necessary, staff should avoid placing any weight on the neck, head or back.

Guidance from organisations like the Security Industry Authority recommends that physical interventions always consider airway safety first. Holding positions should allow natural breathing and be used only for the shortest time needed to regain control of the situation.

Why monitoring after restraint is just as important

Once a person is restrained, the job is not over. Monitoring needs to continue until the person has fully recovered and is breathing steadily. This includes checking skin colour, responsiveness and physical condition. Any signs such as shallow breathing, limpness or verbal distress need an immediate response. Trained staff should know how to reposition the individual safely and request medical support when needed.

If someone says they cannot breathe, this must be taken seriously every time. Listening and observing closely can prevent an avoidable incident.

Training, responsibility and professional conduct

Security teams across the UK should receive practical training that goes beyond theory. Staff need to understand how restraint affects the body and how to respond when something does not look right. Refresher training and scenario-based learning help to build confidence and judgement.

Standards for conduct are set by the SIA and reflect the duty of care security professionals hold. Practising safely means using the least force necessary and considering the physical and emotional state of the individual at all times.

Legal duties and consequences

UK law makes clear that individuals who are restrained must be kept safe. If they are harmed due to poor judgement or failure to act, staff and organisations could face serious legal consequences. This includes action under health and safety law or claims under human rights legislation.

To avoid these outcomes, incidents should be well documented, with all actions and observations recorded. Use of body worn cameras and incident reports helps ensure transparency and supports accountability.

Practical steps to reduce risk every day

Security workers who are well trained and alert to warning signs make a big difference in preventing harm. By choosing safer restraint options, monitoring carefully and acting quickly when needed, staff help reduce the chance of serious outcomes. Doing the job well means treating every person with care and respect, even in high stress situations.

If you work in security and want to keep your skills up to date,

This article is for informational purposes only and does not constitute legal or medical advice. Please refer to official guidance or consult a qualified professional for specific advice.