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Consider the situation where a psychiatric nurse or perhaps a paramedic needs to assist in sedating someone.

Generally they have several staff restrain the patient pretty much one on each limb. I know this from speaking to psychiatric nurses that I used to train with. But is there a way that one person could do this on their own? The sedative usually is administrated by a Doctor if I recall correctly who needs to be called from their office which may take several minutes.

A good solution will need to restrain but not risk injury to the patient. The patient may or may not be in a state where they can feel pain. It might be that there is not a better way to do this than the current methods described above.

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  • Not that I know of. I've seen this done multiple times. They need to put one whole person on each limb. Even then, it's sometimes hard. As a 6 year old boy, I had an eye operation done on me, and I had an adverse reaction to one of the injections they gave me hours before the surgery, a muscle relaxer. I was apparently out of control, and it took 4 nurses to pin me down by each limb. I was just a 6 year old boy. Haha. But when you're having that kind of a reaction to drugs, your strength is multiplied. They don't want to injure you or let you injure yourself. So more people are needed.
    – Steve Weigand
    May 3, 2021 at 14:38
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    I’m voting to close this question because it about the use of force/restraints in a specific circumstance, for which the OP should get proper training from their employer, or professional body. We cannot explain how to restrain someone in crisis safely or legally (e.g. acceptable level of force will differ between jurisdictions).
    – Mike P
    May 5, 2021 at 14:17
  • I don't' actually work in this field. It's more of a theoretical. In any case if there is an approved way of doing this that works that would answer the question. If there is not it still answers the question. From my own martial arts perspective, I would probably go with Judo's Kesagatame because it involves no joint manipulation at all and can be adjusted actively as the detainee struggles or fails to struggle. But I want to know other's thoughts.
    – Huw Evans
    May 5, 2021 at 15:43
  • This question can be asked equally well as, "How can you restrain someone without injuring them?". You can substitute anyone belligerent for the patient.
    – mattm ♦
    May 5, 2021 at 23:28
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    This is a good (and challenging) question. You mentioned that the patient might not be able to feel pain; I'd break that down further and mention that they may be wired differently to normal people and they may be on medications that interfere with or suppress their normal cognitive processes.
    – slugster ♦
    May 6, 2021 at 1:33

2 Answers 2

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As someone who's worked in law enforcement and forensic mental health settings, the key element is to get the person on their back as soon as possible. Most deaths in custody/restraint result from positional asphyxia which is far less likely when supine.

From here, control of the extremities without pressure on the joints is the safest option, so to control the legs you would control just above or below the knee (although many places now use thick mats which you cover the person's legs with and then lie on top of to allow weight to be used but direct pressure to be reduced).

Seated is then a better position than prone, however this requires minimum 3 people to achieve safely to get the person off the floor - one on each arm and a head person. In seated you would control the persons arms with a double handed grip (on their wrist with their elbows close to you is best) and would put your foot on top of and inside their leg.

The exact techniques used would be determined by your place of work and they would then bear the responsibility for any incidents provided you followed the training given. There are no bad techniques, only bad applications and it's incumbent on an employer expecting you to use force to weigh those risks and rewards.

It's important to note that drugs change this hugely - the number of people needed will increase and the likelihood of death increases massively too - don't do drugs kids.

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  • A good answer, but assumes you have a lot of highly trained people on hand to help.
    – Huw Evans
    Jul 2, 2021 at 6:47
  • It definitely does, but these would also be the safest methods (for the restrainee) for untrained people to attempt to employ should that situation ever arise.
    – Rob O'Neill
    Jul 2, 2021 at 10:11
  • I get where you are coming from but if you are "untrained" you don't know how to do this. In any case this question was about a situation involving just you (say a paramedic on the street with perhaps one colleague as per a typical ambulance crew) trying to restrain one person. This is about martial arts after all. I know how it works if you have a team of trained psychiatric workers.
    – Huw Evans
    Jul 3, 2021 at 14:56
  • NB. I have upvoted your answer as 'useful'. But I am not accepting it as it doesn't actually answer my question.
    – Huw Evans
    Jul 3, 2021 at 14:58
  • Hi Huw, The aim would be the same for one or multiple people, get and keep the person on their back, or get them seated if possible. It's difficult to answer the question precisely because there are too many situational factors - I could use (for example) a kesagatame hold to restrain them on their back in one situation, but for a smaller/lighter/frailer subject this may restrict their breathing sufficiently to cause damage similar to leaving them prone. This is why as with all things martial arts related a principles based approach as outlined above is better than a techniques one.
    – Rob O'Neill
    Jul 5, 2021 at 18:28
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I have no experience with psychiatric patients, but assuming I want to restrain someone by myself without anyone getting hurt, my position of choice would be the wrestling hammerlock position with the other person face down. In this position, you have control of the near side arm with it behind the back and your weight on top. You have one hand free.

Hammerlock position

From behind with your weight on top controlling the near arm and body, you can hold the person down without them being able to attack you effectively with hands, arms, legs, or teeth. You can see what the other person is doing with their hands in case they have a weapon. You can put your knees on the ground to lessen the pressure if desired.

Hammerlock is a wrestling term, not a judo or BJJ one. The wrestling hammerlock is not about putting the joint in a position where leverage will damage the joint. It is simply about putting the person's arm behind them where you can control it and they cannot use it effectively. If you want to lock the joint in the sense that additional motion can cause damage, you take the wrist and walk it up the back, pulling the elbow along with it. For control alone without a shoulder lock, you can pin the hand behind the waist, well within normal range of motion.

Contrast this with what can happen in a judo kesa gatame position. The person on the bottom has an arm free with you in front of them; they can grab your ears or hair, poke you in the eyes, and grab things that you cannot see behind you. Since there are no points for controlling the person on their back versus their front, put them on their front and remain behind them.

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    The big catch is not hurting the patient... Hammerlocks are notoriously easy to accidentally break an arm or shoulder if they other person moves the wrong way. Just working in theatre, where people are just trying to fake the movement during a fight scene, I've seen a fair amount of damage.
    – Macaco Branco
    May 3, 2021 at 23:02
  • Huh. I wonder if maybe this is more dangerous in theatre because the people having their arm wrenched generally aren't resisting -- the general rule in stage fighting being that the person being attacked controls the movement -- and additional force is accidentally being applied by someone boosted by adrenalin, or trying to make the movement "look more realistic". In retrospect, almost every case I've heard of, or personally seen, has involved a man putting a woman into a hammerlock, so there might be a factor of relative stature and/or misogyny.
    – Macaco Branco
    May 4, 2021 at 15:14
  • It doesn't matter. I'm seeing laws being made that forbid the use of chokes or any neck manipulation while police officers are attempting to control someone. That's due to highly publicized cases of cops killing people with them. It's not hard to imagine someone in charge at a hospital seeing one of their nurses or doctors trying to apply a neck manipulation hold (even if it's not a choke), and then firing said nurse or doctor. There is a very real risk of being sued for using these kinds of holds, now that awareness of them has spread to the general public. Hospitals can lose their insurance.
    – Steve Weigand
    May 5, 2021 at 14:46
  • The "doesn't matter" part refers to the idea that you can perform a neck manipulation hold safely. Whether or not it's safe makes no difference. It's the optics that matter. And getting fired or sued.
    – Steve Weigand
    May 5, 2021 at 15:11
  • I was referring to the video link. It shows a neck crank.
    – Steve Weigand
    May 5, 2021 at 16:00

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