title: Review of the medical and legal literature on restraint chairs.
abstract: Use of restraint chairs by law enforcement for violent individuals has generated controversy and a source of litigation because of reported injuries and deaths of restrained subjects. The purpose of this study is to review the available medical and legal literature and to allow the development of evidence-based, best practice recommendations to inform the further development of restraint chair policies. This is a structured literature review of four databases, two medical and two legal. The medical review focus was on the restraint chair with additional review of materials regarding other restraint methods and options. The legal review focused on litigation cases involving the restraint chair. The review of the medical literature revealed 21 peer-reviewed studies investigating the physiological or psychological effects of using a restraint chair on humans or primates. Of these studies, 20 were performed on primates. The single human study revealed no clinically significant effects from the restraint chair on test subjects. The legal literature review revealed very few cases where the restraint chair was either a major or minor focus. The overall issues relating to the restraint chair cases involved deviations from set protocols and rarely involved issues with the chair itself. The available medical literature reveals that the restraint chair poses little to no medical risk. Additionally, when used appropriately, the restraint chair alone carries little legal liability. With proper monitoring and adherence to set protocols, the restraint chair is a safe and appropriate device for use in restraining violent individuals.
authors.affiliation: University of California, San Diego Medical Center, Department of Emergency Medicine San Diego, California, 200 West Arbor Drive, Mailcode 8676, San Diego, CA, 92103, USA. Electronic address: emcastillo@ucsd.edu.
authors.forename: Edward M
authors.initials: EM
authors.lastname: Castillo
authors.affiliation: University of California, San Diego Medical Center, Department of Emergency Medicine San Diego, California, 200 West Arbor Drive, Mailcode 8676, San Diego, CA, 92103, USA. Electronic address: cjcoyne@ucsd.edu.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Coyne
authors.affiliation: University of California, San Diego Medical Center, Department of Emergency Medicine San Diego, California, 200 West Arbor Drive, Mailcode 8676, San Diego, CA, 92103, USA. Electronic address: tcchan@ucsd.edu.
authors.forename: Theodore C
authors.initials: TC
authors.lastname: Chan
authors.affiliation: University of British Columbia, Department of Emergency Medicine, Victoria, BC, Canada; Vancouver General Hospital, Room 3300, 910 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada. Electronic address: christinehallmd@gmail.com.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Hall
authors.affiliation: University of California, San Diego Medical Center, Department of Emergency Medicine San Diego, California, 200 West Arbor Drive, Mailcode 8676, San Diego, CA, 92103, USA. Electronic address: gmvilke@ucsd.edu.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Vilke
mesh_terms: D002961:Civil Rights / Q000331:legislation & jurisprudence; D006801:Humans; D035846:Law Enforcement; D016365:Liability, Legal; D016134:Organizational Policy; D010146:Pain / Q000209:etiology; D000066550:Physical Abuse / Q000517:prevention & control; D011678:Punishment; D012149:Restraint, Physical / Q000331:legislation & jurisprudence* / Q000523:psychology; D014954:Wrist Injuries / Q000209:etiology
keywords: Chair restraint; Emergency restraint; Physical restraint; Restraint chair; Restraint safety; Restraint techniques