Positional Asphyxia Definition

What is positional asphyxia? Why we should be aware of it? First of all, we should know what ‘asphyxia’ is. So asphyxia is a loss of consciousness which is caused by inadequate oxygen in blood stream. In a forensic, asphyxia is a general world involving certain condition such as problems in inhaling and taking oxygen on the air.

To survive, people must consume oxygen; deliver it to body tissue, and use the oxygen as energy.

There are many ways to classify the cause of asphyxia. This classification system has main category based on the dominant mechanism (airway clearance or blood flow problem). Some of asphyxia involves more mechanism.


Some of the cause of asphyxia including;

Inability to breath:

  • Low oxygen atmosphere
  • Muffling
  • Aspiration
  • Chocking
  • Infection
  • Tumor
  • Trauma
  • Secret or sputum
  • Broncospasme
  • Chest compression
  • Strangulation
  • Postural asphyxia

Chemical asphyxia:

  • Carbon monoxide
  • Cyanide

Then, according to wikipedia, ‘positional asphyxia’ or ‘postural asphyxia’ is a type of asphyxia. This type of asphyxia could occurs when someone’s position prevent the person from breathing adequately. This asphyxia is a significant factor for high number of people die suddenly during restraint by police, prison, military, or health care workers. This positional asphyxia does not only cause sudden death in adults, but also infants.

Some physical restraint techniques may cause positional asphyxia. This is very dangerous thing that should be avoided by police, military, and other professions.

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physical restraint techniques may cause positional asphyxia

physical restraint techniques may cause positional asphyxia. The picture above shows that this is a very dangerous restraint position.
Picture: flickr.com

People may die from positional asphyxia because they could not resist the restrain that can cause inadequate breathing. This asphyxia might be an accident due to person’s carelessness, or parent who place their baby in a bad position where the mouth and nose is blocked, or where the chest cannot expand normally.

Prone Restraint

Recent study suggested that restraining a person in a face down position could cause greater restriction of breathing than restraining a person face up. Multiple cases have been associated with the hogtie or hobble prone restrain position. Many law enforcement and health care workers are now taught to avoid restraining people face down, if the condition should do this face down restraint, the restrain must be for short period of time.

Other factors that can increase the chance of death include;

  • Prolonged restraint
  • Obesity
  • Cardiac and respiratory problems

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Others are like kneeling or otherwise placing weight on the subject and particularly any type of restraint hold around the subject’s neck.

Research measuring the effect of restraint positions on lung function suggests that restraint which involves bending the restrained person or placing body weight on them affects more on their breathing. This is more dangerous than face down positioning alone.

Other restraint positions

Positional asphyxia is not only for face down position. For instance is restraining a person in a seated position. If a person is pushed forward with the chest close to the knees, restraining a person in a seated position may also reduce the ability to breathe and the change of death. This restrain position could be in high risk in cases where the the restrained person has:

  • Obesity or high body mass index (BMI)
  • Large waist girth.
Other restrant positions

Other restrant positions
Picture: wikipedia.com


The positional asphyxia can be deathly in second if there is no immediate resuscitation. Resuscitation in person who exhibit cardia arrest following restraint has proven to be difficult. Even in cases where the subject was in the immediate care of paramedics, resuscitation has failed and the patient has died. The main problem in positional asphyxia is acidosis, so group of doctors has presented a method of resuscitation and correcting acidosis in the blood stream of the victim. In a small study, this method is proved effective. This approach appears to be supported by another report of single case of successful resuscitation.

Debate regarding positional asphyxia

Positional asphyxia is such a controversy amongst researchers regarding the extent to which restraint position restrict breathing. Some laboratory studies showed that the effect of restraint on breathing and oxygen levels in blood stream was limited. Other researchers point out that death in real life positional asphyxia occur after prolonged and violent resistance.

Positional asphyxia due to accident or illness

In case of accident and illness, positional asphyxia could also occur such as epileptic seizure and even fall down a flight of stairs. In infant, the most common parent careless who places their baby in a face down position (under 3 months baby) where the baby’s mouth and nose is blocked.