IPICD Clinical Significance July 2012

2013 Conference Update

Dr. John G. Peters Jr. Ph.D., CLSThe 2013 Institute international conference is fast approaching, so make sure you register for this exciting event. The focus of the 2013 Conference is on investigating arrest-related deaths, and the speakers scheduled are not only very experienced in this area, but also very willing to share their expertise with you. Based upon Conference evaluations from previous years, the 2013 Conference will have fewer speakers, but each speaker will have much more time to present a full discussion of his or her topic. If you have not yet called Anita to register for the 2013 Conference, do it today! Seats are going fast. Dr. Peters

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Research Report Published

The WRAPThe WRAP Restraint System: A Descriptive, Field-Setting Study has been published by the Institute. The 112-page report is broken into 5 chapters. While Chapters 1 and 3 discuss the methodology of the study and also why it was important to conduct the retrospective study, Chapter 2 discusses restraints and sudden death, the frequency of such events, relevant legal standards and statutes, relevant judicial decisions, training and testing liability, the Americans with Disabilities Act of 1990, and contemporary arrest-related death theories. The chapter also contains a thorough discussion of positional asphyxia studies and findings. Chapter 5 contains 18 specific recommendations for trainers, users, and agencies who use or that have adopted The WRAP Restraint System. An Executive Summary is available on the Institute’s Website. The report is available in printed format or as an e-report. Check it out!

Overuse of Anti-psychotic Drugs

The American Psychiatric Association (APA) announced it has questioned the use of anti-psychotic drugs as “first treatments” by doctors. Such drugs are often given by doctors to patients who are experiencing dementia, behavior problems, or insomnia. The APA identified the drugs in question as: Risperdal, Zyprexa, Seroquel, and Abilify. Older drugs that are often used to treat schizophrenia and bipolar disorder are also often misused. USA Today, 9/23/2003, p. 5D

New Prone Maximal Restraint Study (PMR) Results

PMR is defined as placing a person onto his or her stomach, handcuffed behind the back, with the handcuffs secured to the ankles. In this study, researchers scientifically studied the following with respect to hemodynamic stability: measures of cardiac function, including the person’s vital signs; oxygenation stroke volume, inferior vena cava (IVC) diameter, cardiac output (OC), and cardiac index (CI). A previous study had suggested a reduction in IVC when weight was applied to the back. This study involved a group of 25 healthy male volunteers between the ages of 22 and 43 who were placed into 5 different body positions. The body positions were supine, prone, PMR with no weight force and PMR with 50 pounds added to the person’s back area, and PMR with 100 pounds added to the back area for 3 minutes. Researchers’ monitored the volunteers’ heart rate, blood pressure, and oxygenation saturation. Left ventricular outflow tract diameter was also monitored. Although there was a small decrease in stroke volume, the study found no statistically significant differences in cardiac output or cardiac index between the 5 positions. Data show no evidence of hemodynamic compromise in any of the PMR positions when researchers evaluated heart rate, MAP or oxygen saturation levels. The researchers’ conclusion: With or without weight force applied to the back when a person is placed into a PMR position, there was no evidence of change in cardiac output or other evidence of cardiovascular or hemodynamic compromise. Savaser, Campbell,Castillo, Vilke, Sloane, Neuman, Hansen, Shah, & Chan (2013), Journal of Forensic and Legal Medicine.

Agonal Breathing Frequency

As many of you know from your IPICD training, agonal breathing is “agony” breathing, and is often described as “snoring” or “gurgling”. One group of researchers in 1991 set out to study the frequency of agonal breathing. The researchers’ reviewed tape recordings of calls, EMT, and paramedic incident reports (N = 445). The events were described as out-of-hospital cardiac arrests. The data showed that agonal respirations occurred in 40% of the out-of-hospital cardiac arrests. According to the researchers, this is a high frequency. Clark Larsen, Culley, Graves, Eisenberg (1992), Annals of Emergency Medicine.

Remember to include agonal breathing in your training programs.

Wheelchair Bomber

In addition to teaching agonal breathing sounds, IPICD instructors also advise trainers and agencies to include how to search people in wheelchairs. But one must be careful. In Beijing, China’s airport, it was reported that a man in a wheelchair detonated a homemade bomb in a crowded terminal. It was reported the bomb only injured the man in the wheelchair. The Desert Sun, July 21, 2013, p. A12.

New Look Coming to IPICD Website

Keep checking the IPICD Website for its new look. The Website is being redesigned by IPICD’s IT specialist, Jason Peters.

New ECW Tester

ECW Tester A new ECW tester has been developed and is about ready to come to market. Called the ESW Analyzer by Aegis Armor, it is designed to accurately test ECW electrical output and other electrical readings. For more information, please visit www.aegisaxeos.com.

Congratulations to IPICD Grads

The IPICD staff members congratulate those officers who graduated from IPICD programs during the last quarter. Excited Delirium and Agitated Chaotic Event™ instructor programs were held in VA, IA, TN, and CA. Also, congratulations to those individuals who successfully complete the IPICD Arrest-related and Sudden In-custody Death Investigative Specialist™ program.

IPICD Arrest-related Death Investigator Checklist

The IPICD has developed a 4-page Arrest-related Death Investigator Checklist. It will be available on the IPICD Website after the 2013 IPICD Conference. All Conference attendees will be given a copy of this comprehensive checklist.

Sad, but True

The Los Angeles Times reported the mother of a 3-year-old girl and the mother’s boyfriend were being held on $100,000 bail after the young child tested positive for methamphetamine while at a hospital being treated for a fever. A toxicology screen showed the 3-year-old girl had “meth” in her system. 9/17/2013, p. AA4.

Attend One of these Programs

If you cannot sign-up for one of the following IPICD programs, simply call Anita and arrange to HOST a program:

Excited Delirium and ACE Instructor
  • Nevada: 10/14-15/2013
  • Utah: 11/6-7/2013
  • Maryland: 12/2-3/2013
  • Idaho: 12/11-12/2013
  • Illinois: 2-4-5/2013
Developing Defendable Psychomotor Assessments
  • Nevada: 10/16/2013
  • TN: 5/2/2014
Arrest-related Death Investigative Specialist™
  • IL: 10/23-25/2013
  • Maryland: 12/4-6/2013

Fatal Drug Overdoses Rise

The Los Angeles Times has reported that fatal drug overdoses have risen in the United States for the 11th straight year. According to the National Center for Health Sciences, 38,329 people died in 2010 from drug overdoses. Approximately 22,000 deaths (57%) involved prescription drugs. Oxycontin and Percocet deaths were 9,400. 2/23/2013, p. A8.


The following Americans for Effective Law Enforcement (AELE) programs are being held in Las Vegas, Nevada. For more information, please visit www.aele.org.

Lethal and Less-Lethal: 10/7-9/2013
IA and Discipline: 12/16-18/2013
Jail I: 1/20-21/2-14
Jail II: 1/22-23/2014
Monitoring Use of Force: 3/3-5/2014

Remember: The IPICD 2013 international Conference counts as 1 course toward the AELE Certified Litigation Specialist designation.

LAPD paid out $$$$ in Lawsuits

It was reported that the city of Los Angeles, California has paid out approximately $110 million in lawsuits that were filed by police officers against the department. $31 million was paid out in employment liability cases, and does not include worker’s comp claims. Some claims were for racial discrimination, and harassment. Awards ranged from $85,000 to $4.3 million. Los Angeles Times, 6/29/2013, p. B7.

Clinical Significance
Editor: John G. Peters, Jr., Ph.D., CTC, CLS
Publisher: Institute for the Prevention of In-Custody Deaths, Inc., 209 South Stephanie Street, Suite B249, Henderson, NV USA 89012.
© 2013. All rights reserved. For reprint permission please contact the Editor.

Happy Halloween