Physiological Effects of a Spit Restraint Device Saturated With Artificial Saliva.

BACKGROUND: Spit restraint devices, also referred to as spit hoods, spit masks, or spit socks, are used by law enforcement and medical personnel to minimize transmission of communicable disease from bodily fluids from agitated individuals. Several lawsuits have implicated spit restraint devices as contributing to the death of individuals who are physically restrained by means of asphyxiation due to saturation of the mesh restraint device with saliva. OBJECTIVES: This study aims to evaluate whether a saturated spit restraint device has any clinically significant effects on the ventilatory or circulatory parameters of healthy adult subjects. METHODS: Subjects wore a spit restraint device dampened with 0.5% carboxymethylcellulose, an artificial saliva. Baseline vitals were taken, and a wet spit restraint device was then placed over the subject's head, and repeat measurements were taken at 10, 20, 30, and 45 min. A second spit restraint device was placed 15 min after the first. Measurements at 10, 20, 30, and 45 min were compared with baseline using paired t-tests. RESULTS: The mean age of 10 subjects was 33.8 years, and 50% were female. There was no significant difference between baseline and while wearing the spit sock for 10, 20, 30, and 45 min for the measured parameters including heart rate, oxygen saturation, end-tidal CO2, respiratory rate, or blood pressure. No subject indicated respiratory distress or had to terminate the study. CONCLUSIONS: In healthy adult subjects, there were no statistically or clinically significant differences in ventilatory or circulatory parameters while wearing the saturated spit restraint.

Physiological effects of a spit sock.

OBJECTIVES: Healthcare providers and law enforcement utilize spit socks to prevent exposure to communicable diseases transmitted by bodily fluid projection from agitated individuals. There are cases in which death is reported due to breathing being limited by a spit sock. There are no formally published studies on their use and safety. The aim of this study was to evaluate whether wearing a spit sock causes a clinically significant impact on breathing. METHODS: Subjects sat with the spit mask over their heads for 15 min and their vital signs and ventilatory parameters were recorded after 5 min, 10 min and 15 min. Data were compared to baseline using Student's t-test with 95% confidence intervals using SPSS. RESULTS: The median age of the 15 subjects was 28 years and 53% were male. There was no significant difference between baseline and wearing the spit sock for 5, 10 or 15 min for heart rate (p = 0.250, p = 0.181, p = 0.546), oxygen saturation (p = 0.334, p = 1.00, p = 0.173), end-tidal pCO2 (p = 0.135, p = 0.384, p = 0.187), and diastolic blood pressure (p = 0.485, p = 0.508, p = 0.915). The respiratory rate was not significantly different after 5 and 10 min (p = 0.898, p = 0.583), but decreased at 15 min (p = 0.048). The systolic blood pressure was lower after 5 and 10 min (p = 0.028, p = 0.045), but not significantly different at 15 min (p = 0.146). No subject indicated distress nor did the study need to be terminated due to pre-determined concerning vital signs or ventilatory parameters. CONCLUSIONS: In healthy subjects there were no clinically significant changes in the physiologic parameters of breathing while wearing a spit sock.

Further study on the physiological effects of an alternative spit mask.

OBJECTIVES: Spit masks are used by law enforcement officers and healthcare providers to protect themselves from the spread of communicable disease by subjects who pose a potential risk of biological exposure by spitting. Little research is available regarding the safety of these masks. However, concerns surround the ability of subjects to properly ventilate while wearing these masks as there are several anecdotal incidents of asphyxiation. A recent pilot study performed by our group showed no significant changes in ventilatory or circulatory parameters in healthy adults wearing a standard spit mask. In this study we aim to further this baseline research by testing physiological parameters in subjects wearing an alternative design of spit mask. METHODS: This prospective study evaluated the changes in respiratory and circulatory parameters in healthy adult subjects wearing a Safariland Tranzport Hood spit mask (SKU: 8320-0-2C) at rest. Baseline measurements of pulse, blood pressure, respiratory rate, oxygen saturation, and end-tidal CO2 were taken while sitting at rest. The spit mask was then placed over the subject's head and repeat measurements were taken at 5, 10, and 15 min. Measurements at 5, 10, and 15 min were compared to baseline using paired t tests with 95% confidence intervals using SPSS. RESULTS: A total of 15 subjects participated in the study. There was no significant difference between baseline and at 5, 10, and 15 min after spit mask application in heart rate (p = 0.246, p = 0.785, p = 0.502, respectively), oxygen saturation (p = 0.751, p = 0.334, p = 1.00, respectively), respiratory rate (p = 0.866, p = 0.270, p = 0.106, respectively), systolic blood pressure (p = 0.385, p = 0.481, p = 0.182, respectively), and diastolic blood pressure (p = 0.832, p = 0.516, p = 0.597, respectively). For end-tidal CO2, there was no significant difference between baseline and at 10 and 15 min (p = 0.586, p = 0.416, respectively). End-tidal CO2 was significantly increased from baseline at 5 min (p = 0.042). CONCLUSIONS: In healthy adult subjects, there were no clinically significant differences in respiratory or circulatory parameters while wearing the Safariland Tranzport Hood spit mask.