Police and the ambulance service need a better understanding of Acute Behavioural Disturbance (ABD) if they are to reduce the tragedy of deaths in custody.

That was a key message by Dr Meng Aw-Yong, President of the British Academy of Forensic Science, in his address to the Federation’s Post Incident Procedures (PIPs) seminar in Hinckley.

A leading medical expert, he explained how factors such as the stress of being restrained during an arrest, combined with adrenaline, a toxic build-up of acidity, carbon dioxide in the body and lack of oxygen can have fatal consequences – particularly if the person under arrest has taken drugs.

Dr Aw-Yong told the seminars 250 delegates: “There needs to be a greater awareness of ABD in the emergency services and control rooms. We’ve said to the Government that there must be a joint response because this is a medical problem and often it is the police left to carry the can. If you have to restrain someone, the longer you do so the greater the risk of death – the way to reduce that is by sedation and Taser also has a part to play.”

He acknowledged that the problem with using Taser in situations where a target is worked up to the point of frenzy and is at risk of death – is that any fatal consequences could be attributed to the Taser. However Dr Aw-Yong said it is key to subdue the person in order that they can be sedated and thus the acid levels will reduce, and Taser can be a vital tool in achieving this.

He gave examples of deaths involving police restraint, including one where the detainee had not been examined by a medic and had died two hours later in custody. And in a different case officers had done everything they could to save a collapsed suspect, even defibrillating him, but no ambulance came because neither the police nor the ambulance service control rooms had a proper understanding of the risks of ABD. This needs to be addressed, said Dr Aw-Yong.

Delegates were told that there needs to be a tripartite response to situations where ABD could be a factor, involving police, the ambulance service and hospitals. He added that in London there have instances where a fast responding paramedic is sent ahead to administer a sedative before an ambulance arrives.

The topic was covered as part of a session called the Physiology of Restraint and will continue into Day Two when a police restraint scenario will be acted out on stage by trainers wearing heart rate monitors and oximeters.