The type of restraint used at this facility has not yet been released. However the last time Daystar got into a jam it was using the basket hold in the prone position. Even the Feds had the wherewithall to recognize that the basket hold in the prone position is a bad idea.
The GAO in its 1999 Report on Restraint Use in MH Facilities called the prone basket hold the prone wrap. The GAO probably named it this because that’s what NY was calling the restraint under NYS Office of Mental Hygiene. However to most people familiar with common restraint techniques, the technique GAO refers to as the “prone wrap” is the basket hold gone prone.
Putting a client in a basket hold and restraining them face down is a bad idea. As we have been saying, all prone restraints are not equal. Some can be used safely, others are simply not safe. The basket hold in the prone position is an example of a face down restraint that should be avoided at all costs.
The way the basket hold works is that a clients arms are criss crossed over their upper body, chest, torso, abdomen. Staff is positioned behind the client and grasps the client’s wrists. Some agencies like the basket hold because it contains the clients hands so they cannot pinch or grab. The problem with the basket hold is that it is not very stable because the staff’s connection is at an arms length holding the client’s wrists. This gives a lot of leeway to the client to struggle and fight against the restraint. As a result of this dynamic, the basket hold often destabilizes sideways. Now you have staff and the client on the floor on their sides, not very stable, not very comfortable and if the client continues to struggle the staff is going to want to get into a dominant (top) position. When this happens you have a client whose arms are now a criss crossed lever across their abdomen. You don’t even need the weight of the staff person to make this a very dangerous situation.
Moral of the story is, if you are going to use the basket hold make sure staff knows that they have to transition into a different restraint or release the restraint completely if the basket hold destabilizes and goes prone.