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By London Security College

Positional Asphyxiation in Security

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What is Positional Asphyxiation?

Positional asphyxiation occurs when a person’s body position restricts their ability to breathe, leading to oxygen deprivation and, in severe cases, death. For security officers and door supervisors, this risk is exceptionally high when restraining individuals, especially in high-stress situations like dealing with aggressive patrons, breaking up fights, or detaining violent individuals.

Real-World Example

In 2013, a door supervisor in the UK was convicted of manslaughter after a restrained customer died due to positional asphyxiation. The individual was pinned face down, causing them to suffocate. This case highlights security professionals’ legal and moral responsibilities to use restraint techniques properly.

How Does Positional Asphyxiation Happen in Security and Door Supervision?

Security professionals, particularly door supervisors working in nightclubs, pubs, and events, often face volatile situations where restraint may be necessary. However, improper restraint techniques can be fatal.

Common Risk Factors in Security and Door Supervision:

Placing weight on a person’s chest or back– This restricts lung expansion and leads to suffocation.
Holding someone in a prone (face-down) position for too longsignificantly increases the risk.
Restraining someone with their neck or chest compressed– This limits airflow.
Pinning someone against a hard surface, like the floor or a wall, for an extended period.
Failing to monitor the person after restraint– Unconsciousness can occur quickly.
Restraining intoxicated individuals– Alcohol and drugs can amplify respiratory distress.

How Long Does It Take for Positional Asphyxiation to Become Fatal?

A person struggling to breathe may become unconscious in 30 seconds to 2 minutes, and death can occur within 3 to 5 minutes if oxygen supply is cut off.

Shocking Statistics

Between 1998 and 2020, over 100 restraint-related deathswere reported in security and law enforcement cases in the UK. (Source: INQUEST UK)
A study found that 90% of positional asphyxia deaths involved individuals held face-down (prone restraint)for more than 2 minutes. (Source: The Journal of Emergency Medicine, 2019)

How to Prevent Positional Asphyxiation in Security and Door Supervision

1. Avoid Face-Down Restraint (Prone Position)

If restraint is necessary, do not keep someone face-down.
Move them to a seated or side positionas soon as possible.

2. Minimise Force and Duration

Restraint should only be used when necessaryand for the shortest time possible.
Avoid excessive pressure on the neck, back, or chest.

3. Monitor Breathing and Consciousness

Ask the individual if they can breatheand watch for signs of distress.
If the person is struggling or stops responding, release them immediatelyand check for a pulse.

4. Use Proper Restraint Techniques

Control limbs instead of pinning the torso.
Use team tactics—never restrain someone alone if avoidable.
Communicate with your teamto assess the situation.

5. Know the Risk Groups

Specific individuals are at higher risk of positional asphyxiation:
✔ Intoxicated persons (alcohol/drugs)
✔ Individuals with pre-existing health conditions (asthma, obesity, heart disease)
✔ People under extreme emotional distress (panic attacks, mental health issues)

6. Provide Immediate First Aid If Needed

If a restrained person becomes unresponsive, place them in the recovery position.
Call emergency services immediatelyif breathing is compromised.
CPR should be performed if they stop breathing.

Best Practices for Door Supervisors

Scenario 1: Dealing with an Aggressive customer at a Nightclub

Wrong approach:
A door supervisor takes down an aggressive, intoxicated customer and holds them face-down on the pavement while waiting for the police. The customer struggles, then stops moving.

Right approach:
✔ De-escalate first—use verbal techniques before resorting to restraint.
✔ If restraint is unavoidable, do not hold the individual face-down.
✔ Monitor their breathing and keep them in a seated or side position.

Scenario 2: Breaking Up a Fight at a Pub

Wrong approach:
A group of door supervisors restrains a brawler by pinning them against a wall with excessive force, restricting their chest movement. The individual gasps for air and collapses.

Right approach:
✔ Separate individuals quickly and use minimal force.
✔ If restraint is required, avoid chest compression and move them into a safer position as soon as possible.
✔ Keep them monitored until they calm down or police arrive.

Legal Implications for Security Officers & Door Supervisors

Failing to prevent positional asphyxiation can result in:
❌ Criminal charges – Manslaughter, negligence, or assault.
❌ Civil lawsuits – Compensation claims from victims’ families.
❌ Loss of SIA License – Security professionals can be banned from working in the industry.

Relevant UK Cases

In 2017, a bouncer was jailed for manslaughterafter an intoxicated man died from positional asphyxiation during restraint. The victim was held in a prone position for several minutes.
The SIA mandates that door supervisors receive trainingin conflict management and restraint techniques to prevent such fatalities.

The Responsibility of Every Security Professional

Security officers and door supervisors have a duty of care when dealing with confrontational situations. Understanding positional asphyxiation, applying safe restraint techniques, and prioritising de-escalation can save lives and protect security professionals from legal consequences.

Key Takeaways:

✔ Never restrain someone face-down for long periods.
✔ Monitor their breathing and response.
✔ Use the least amount of force necessary.
✔ Train in de-escalation and safe restraint techniques.
✔ Recognise when to call for medical assistance.

By following these best practices, security professionals can ensure public safety while protecting themselves from legal risks.

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