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Transport Techniques

Transport techniques vary greatly in intensity and the numbers of people

necessary to perform the technique. The techniques are designed so you may

move from the least restrictive to a more restrictive technique if absolutely

necessary for safety. In almost all situations, it is important to know that YOU

can decide not to use a more restrictive procedure. Unless you are truly dealing

with a life threatening situation to the person or others in the immediate area,

slowing down, talking softly to the person and waiting could help calm the

situation and avoid risk of injury.

Which technique you choose depends on the person’s size and strength,

your knowledge of past behaviors and medical knowledge of the person. The

number of people available to assist you and their level of training will also

influence your choice. Safety of everyone involved must be your primary con-

cern.

It is very important to have a clear understanding of what your intentions

are in initiating the restrictive intervention. Most injuries to the person and/or to

staff happen during carries and pins on the floor. Careful consideration must be

given to the degree of perceived imminent danger, the surrounding environment

and resources readily available to help calm the situation.

Carrying a person and pinning him/her on the floor is very humiliating

and can be dangerous if not performed correctly. Your relationship with the

person can be damaged by your participation in this technique. Again, only use

this technique when necessary to maintain safety and all other measures have

failed.

Transport techniques requiring more than one person must be executed

with much teamwork if they are to be effective. Teamwork is best accomplished

when someone is designated as the leader. A rule of thumb that is often used for

that designation is: “The person who began the intervention is considered in

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charge.”

The leader, however, can be subject to emotions and to physical injury.

The in charge role should be assumed by someone else if:

1. Objectivity is lost.

2. Injury occurs.

3. Exhaustion occurs.

4. A safe exit is prevented.

5. A different person may appear less threatening or less provocative to

the person.

For many people, simply being lifted off the ground is frightening.

When combined with giving up almost total physical control, the experience can

be terrifying. Sometimes staff are so anxious to end the incident that they will rush

to the transport techniques and escalate the situation more than necessary. Con-

sider stabilizing the person “in place” and using methods to calm the situation.

Carrying a person should only be done when there are clear safety issues that

outweigh the increased risks. Staff must take all precautions not to drop the

person on hard surfaces or lay the person on surfaces that may cause skin abra-

sion such as carpets or concrete. Note: children and small adults should be given

the same level of diplomacy we use with those who are large and strong enough

to intimidate us.

Sometimes staff is so focused on control that they demand complete

submission (the person must keep absolutely still and/or quiet) before

deescalating the intervention and releasing the person. Use of the restrictive carries

and pins on the floor does not mean that the person should be held totally

immovable or that that person cannot be allowed to talk. Using good judgement

about how much freedom to allow can help.

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LIMITED CONTROL WALK

The procedure...

*1. Staff approaches the person fromthe side and slightly to the rear.

*2. Place hand closest to the personslightly above person’s elbow andother hand on person’s wrist.

*3. Place arm in an L-shaped position.Using a cupped hand above theperson’s elbow, use slight pressureforward to prompt walking.

Ask yourselfMust the person movefrom the area at thismoment in time?

Could you accomplish yourobjective by talking to theperson and inviting him/her to join you?

Could waiting with theperson prevent furtherescalation?

How would your touchingthe person be received? (Asa helping hand? Acontrolling hand? Bringingup issues related to pastabuse?)

If you are unsure of theanswers to these questions,waiting can buy you andthe person time to figureout the best solution foreveryone involved.

Anytime a person resistsor “throws” a punch, blockthe punch and then release.

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LIMITED CONTROL WALK, continuedConsiderations

Only use when touchingthe person will not escalatethe situation and/orrequire physical support.

Don’t mistake avoidance(pulling or stepping awayfrom you) for aggression.The person may not wantto go with you but mayalso be de-escalating.

Be aware that when youchoose a method ofcontrol rather thangetting the person’sagreement, this can harmyour relationship with theperson.

Relax your appearance byopening your hands,talking softly, etc. It isimportant that yourmanner not be provoking.

When you keep yourresponses to the minimumneeded to maintain safety,you help promote a safe,conflict-free environment.

As you approach theperson, talk to him/herquietly. Discuss whereyou would like the personto go. Suggest that thetwo of you go together.Ask if they are ready togo at this moment.

Look for opportunities toback off from touchingthe person above the elbowand wrist. Or you mayredefine the touch as warmsupport, ie. moving thehand to the shoulder for asoft pat.

Be Respectful! Remember moving away can be a valid means of de-escalating the situation. This isnot a moment for power struggles. In a physical confrontation, everyone loses. The other personloses dignity and self-control. You lose time and energy, and the your relationship can be damaged.

4. Use the secured arm to block anypunch the person might throwwith his free arm. Release thehold and move away and monitorfor safety.