Latest Forum Postings and Discussions
- Syndrome in “In-Custody Death Syn
During my career as an FBI agent, I provided expert reviews on numerous in-custody death cases. A common point of confusion during legal review and risk management is the discrepancy surrounding the recognition of “in-custody death syndrome.” This term is acknowledged by the American College of Emergency Physicians (ACEP), but not by the American Medical Association (AMA).
The key distinction here is that “in-custody death syndrome” refers to a syndrome rather than a specific explanation of direct causes and effects. ACEP defines this syndrome as a combination of physiological, medical, and contextual factors that may contribute to death in individuals while in police custody, often exacerbated by elements such as stress, drug use, and restraint.
While the AMA is concerned with the treatment of individuals in custody, it does not formally recognize “in-custody death syndrome” in the same context as ACEP.
In medical terminology, “syndrome” describes complex presentations that may involve multiple organ systems and can manifest with a variety of clinical symptoms, especially when the exact cause is not clearly identified. This term serves as a valuable framework for clinicians, allowing them to communicate about a related group of signs, symptoms, and situations, even when the underlying etiology is not fully understood.
Overall, I support the use of “in-custody death syndrome” because it plays a crucial role in rapidly identifying, diagnosing, and treating critical and potentially fatal conditions that require timely recognition and intervention. For legal review and risk management, I concur with the AMA that each case must be assessed on its individual merits, with a focus on identifying the exact causes and effects.
- Carotid Restraint – Effects on Airway
The carotid restraint technique, often debated in the context of use-of-force protocols, has various myths and facts associated with its effects on the airway. Here’s a concise overview on its airway effects:
Facts:
Temporary Airway Obstruction: Properly applied carotid restraint may lead to temporary airway obstruction, primarily through reversible soft-tissue obstruction and the subject’s voluntary Valsalva maneuver.Mechanisms of Obstruction:
Reversible Soft-Tissue Obstruction: This occurs when the tongue or surrounding soft tissues block the airway, particularly if the person applying has a muscular arm, or the subject of carotid restraint is resisting the restraint by tucking their chin.
Valsalva Maneuver: The subjects often involuntarily engage in the Valsalva maneuver in anticipation of carotid restraint, blocking airflow initially and temporarily.
No Permanent Damage: When executed correctly, carotid restraint should not result in permanent occlusion to central airway structures.
Myths:
Permanent Airway Damage: There’s a misconception that carotid restraints cause irreversible harm to the airway, which is not supported by proper application guidelines.Universal Effectiveness: The effectiveness and safety of carotid restraints can vary significantly based on the individual’s anatomy, sensitivity, and the situation at hand, so it’s not a one-size-fits-all solution.
Simplicity of Technique: The technique requires specific training and understanding of anatomy to apply it safely, countering the notion that it can be used indiscriminately.
Understanding these facts and myths is crucial for law enforcement and medical professionals when discussing use-of-force measures. Further training and education can help reduce confusion and ensure that techniques are applied safely and effectively.
See carotid restraint reference:
haxor.group 