Category: Mental Health/Drugs/Alcohol

The audible signs of positional asphyxiation

A man who is dying from positional asphyxiation will not speak at a normal, conversational pace.

He will speak in short, repetitive statements that fade and trail off at the end, in an obvious rhythm matching their short breaths; they are unable to breathe deeply enough to construct a longer sentence.

Typically, they panic and start pleading, their voice cracks and changes pitch, display acute fear and become less coherent over time.

They may make nonsensical statements, begin asking for help from people who are not there, ask for their mother, and so on.

When sudden tranquility follows vigorous resistance, there is an extreme risk of death.

These things emerge consistently during positional asphyxiation, but they are often disregarded or not recognised by police and other workers.

This can happen despite education and training on the matter.

However, the signs are easy to identify once you’ve observed the pattern across multiple incidents in real time and heard it for yourself.

For training and education purposes, this video depicts several instances where men have died in custody after being restrained. Viewers will hopefully notice a pattern emerging in each instance.

Aboriginal man dies in police custody – Kumanjayi White

On Tuesday 27th May 2025, 24YO Kumanjayi White was arrested after allegedly stealing food and assaulting a security guard who’d confronted him inside a supermarket in Alice Springs. He died in custody a short time later. What really happened, and who is at fault?

Related:

“I CAN’T BREATHE” – how cops accidentally kill, and how to stop it

Man shot by police while filming himself in gunfight

We tend to make a lot of assumptions about how people do or do not behave under stress, in a gun fight, after they are shot, and so on.

The “normative assumption” or “presumption of rationality” is the tendency to expect that other people will behave in a reasonable, logical, or rational manner in a given situation. This assumption often leads to misjudgments when others act in ways that are irrational and unpredictable.

This can result in poor tactical and strategic decisions.

You will never be able to understand what motivates some people, or the logic behind their behaviour, and that’s fine. Always leave part of your mind open to the possibility that things could go pear-shaped in an instant.

The gentleman in this video, for example, is completely irrational. You will not make sense of his behaviour. He will not respond to reasonable directions. He is not acting in his own best interest, he is not even responding to a gunshot wound to the chest the way you would expect.

Pain compliance fails again

CLICK HERE TO WATCH ON X

In this video I break down the errors made by police before the shooting of Elroy Clarke.

Some viewers may find this content disturbing. This video is not intended for entertainment, but for education and training purposes only. My objective is to prevent violence and trauma, not to glorify, encourage, or incite it.

Source – Critical incident video:
https://www.youtube.com/watch?v=vASxVQYkbSc

News coverage:
https://www.nbc-2.com/article/bodycam-video-deadly-shooting-unarmed-man-florida/62720131

“I CAN’T BREATHE” – how cops accidentally kill, and how to stop it

FOR EDUCATIONAL PURPOSES ONLY – CONTENT MAY DISTURB AND OFFEND, VIEWER DISCRETION IS STRONGLY ADVISED.

See bottom of this post for download links to the complete video and printable diagrams.

I give permission for the video and attached documents to be downloaded, played, modified and printed anywhere for free – only for the purpose of education.

TOPICS

00:00 – Intro
03:50 – Excited delirium
05:19 – Why are police involved in the first place if we’re talking about medical issues?
06:12 – Death in custody and sudden unexplained death
07:26 – Monitor your own state of mind when dealing with the patient
08:48 – De-escalation
09:54 – “Super Human Strength”
11:01 – Ability to absorb punishment
11:50 – Pain compliance
12:18 – Pain compliance loop
13:21 – Tasers
13:55 – Positional asphyxiation
14:25 – Do not lay prone for too long
14:55 – “I can’t breathe”
18:07 – Banning pressure – my opinion
19:06 – Examples set by martial artists
19:32 – A personal anecdote
20:12 – Restraint-resistance loop
20:51 – Sudden calm
21:22 – Do not make calmness a condition of your use of force
21:44 – Piling on
22:33 – What we lack in training
22:58 – Minimum force in minimum time
23:34 – Access to risks
24:06 – Caution with handcuffs
24:50 – Biting
25:11 – Position in cell/transport – monitor constantly
25:36 – You are always being recorded
26:31 – You are at the mercy of the world
27:24 – Final thoughts

Download video here

Preventing Death In CustodyDownload

Some excellent feedback from a paramedic in the Reddit thread for this video.

How to prevent death in custody – positional asphyxiation, excited delirium, best practice methods and more [28 minutes]
byu/PaperworkPTSD inProtectAndServe

Text wall incoming: I would like to add some comments here. I am a paramedic in the urban U.S., so I do not know the training or the things that are taught to LEO, but I would offer some alternative perspective. This was a well thought out video, but I would also add some tools/methods that I have used/seen used to help expedite the process.

  1. This was a very thoughtful video, and succinctly emphasizes your position when dealing with psych/overdose/mental health patients in delirium. Which is, in between a rock and a hard place. These people need medical evaluation and intervention, which often Law enforcement is ill equipped to provide. It then becomes a matter of how quickly can you get the ambulance to you to assist. Normally, EMS will not go into active scenes because our defense profile is much less robust than yours. But getting on the radio quickly will ensure that once you have compliance, or even 60-75% compliance, the ambulance is already on the way. Even on your way to the call, if your call notes describe someone who will need an evaluation, just start us. If we get pissy when we get there and its not super serious, thats on us and I hope you dont have that kind of working relationship with your EMS agency, because thats a junk attitude for us to have. Better an easy evaluation and refusal than a cardiac arrest.
  2. There were many clips in this video that show prone positioning, and the continued struggle. OP did a good job of alerting to the cycle of “movement/restraint” that so many of us get into, and how that leads to bad outcomes. If you have to prone someone, then do that, but if the ambulance is coming, there are also safer ways to restrain once we get onscene. The primary intervention is sedation. We all want that person to stop thrashing, so we have to get our drugs onboard. However, once we get there, you now have force multipliers. Do not shy away from using us as help to restrain while the medication takes effect. Limb joint restraint, waist and shoulder control can all be had while prone if need be, and take pressure off the chest. And to be clear, even pressure on the lower back where the abdomen would be can cause asphyxiation, by not allowing proper expansion of the diaphragm.
  3. Please continue to be observant. Many times, once EMS arrives on scene, the police tend to lower their security posture because “EMS is onscene” and it is a medical patient. But I have been stabbed by a patient with APD standing next to her because they were talking to themselves while I was doing my thing. Anyone who needed EMS and is hyperactive is by definition unstable. Please be ready to jump back into the fight. We may also have to use you as our own force multipliers.
  4. The pathophysiology of these patients is unpredictable. The reason why these people suddenly arrest with seemingly no pressure is because of whats happening inside the body. Extremely simplified basically, the drugs/psychosis/etc are causing an unregulated adrenaline dump, giving them their super strength, or their resistance to control techniques and the like. Once their body uses up all of their adrenaline, they’re going to arrest. Our sedation medications add onto that effect, especially if we have to give a double dose because of their extreme adrenaline dump. Which means that predicting when they stop fighting is a nonstarter. Once you go hands on, at any point in time, they may run out of energy and go into arrest, ems or no ems assistance. Look for the signs, and act appropriately.
  5. Thank you OP for not saying that Ketamine from paramedics kills these people.

Sorry for the long wall, I’ve been a paramedic for 11 years-ish now and teach both LEO/EMS team patient control, and basic resuscitation to the police I work with. You guys got the short end of the stick in dealing with these patients, and I dont want any of these cases to happen to you guys.

Male violence and gendered violence

There is a popular belief in Australia that domestic violence, and violence generally, is getting worse. However:

If homicide is the yardstick by which the level of violence in society is measured, then the belief that violence is increasing in Australia cannot be substantiated.

https://www.aic.gov.au/publications/tandi/tandi359

Most discussion has centred around women as victims of homicide, however, men account for about 70% of homicide victims. Over the last 30 years, all homicide has been falling.

Women are certainly over-represented in intimate partner homicide, but these numbers are falling along with the overall count:

The likely cause of the drop is due to the following factors:

  1. Improved socio-economic conditions, including employment opportunities, better education, economic stability
  2. Public health initiatives to address mental health issues and substance abuse – we know that people with mental health drug abuse issues are over represented as homicide offenders
  3. Demographic changes, because we have an aging population who is less likely to commit crime
  4. Improved law enforcement and judicial response, with more effective strategies, crime solving, community policing and prevention measures assisted by technological advancements

Further pursuing these issues will ensure that homicide continues to fall; conversely, a decline in our standard of living, and public health services, could result in more violence in the long term.

Also missing from the conversation is the fact that men are victims of male violence at a higher rate. If we want to prevent the murder of women, we have to protect men also.

All these points and more are discussed in the above video.

Police officer stabbed to death moments after arriving on scene – Las Cruces PD

Body Cam Video
CCTV Video

A stark and horrifying example of two things:

  1. The danger posed by knives, even when we are armed with a gun – you CAN bring a knife to a gun fight and win if you’re close enough.
  2. Not all situations involving mental health issues can be de-escalated verbally. Police have often been criticised in the media for shooting within seconds of arriving at the scene – this incident demonstrates the kind of situation which can lead to that happening.

Patrol Officer Jonah Hernandez was stabbed to death while responding to a trespassing call at the 300 block of South Valley Drive in Las Cruces.

A witness to the stabbing shot the suspect while another witness called 911 for help.

Officer Hernandez was transported to MountainView Regional Medical Center where he died from a knife wound to his neck.

The subject had a lengthy criminal record and mental illness.

Officer Hernandez had served with the Las Cruces Police Department for two years. He was survived by his wife and two sons.

Officer Down Memorial Page

Defense against blunt and edged weapons – a basic guide
Knives vs guns, why police shoot, and why they don’t “just shoot the legs”

Man taken to ground in street fight, brutal armbar follows

According to the source of the video on Reddit, this fight started after the drunken older man had been arguing with a group for about 10 minutes and was given many chances to leave.

The man wearing the ADCC hoodie (Abu Dhabi Combat Club, a prestigious submission grappling tournament) kicked off his footwear shortly before the video starts. Then:

Strikes -> clinch -> takedown -> mount -> armbar -> head stomps from armbar -> mount -> elbows.

Bystanders offered to call an ambulance for the older man following the fight, however he refused and kept saying that a bunch of “homeless guys” had attacked him.

As I’ve explained in a previous post, the standing vs ground debate is a red herring. Sometimes going to the ground is the optimal strategy, sometimes it’s not. In all cases, grappling skills are necessary whether you want to stay standing or not.

Saying “never go to the ground in a street fight” is idiotic, and at best a misguided oversimplification.

In this instance, the man who performed the armbar was not jumped by a group, was not stabbed, there was no glass and AIDS needles and lava on the ground.

It also starkly illustrates the effectiveness of join locks. This is not a submission, he did not wait for his victim to tap. He just destroyed that arm.

None of this is to say that his behaviour was justified, that’s up for you to decide. Where I live, it would be considered excessive and serious charges would follow. Make sure you understand local laws before using force.

The standing vs ground debate in martial arts