Section four Appendices start of the restraint using a designated phrase. (e.g. ‘I now have control of this incident’). p. If a suitably trained member of staff not involved in the actual restraint process is present they should become the Controller of the restraint as soon as practical. q. Control of the restraint will pass between Controllers only when offered and positively accepted using designated phrases (e.g. ‘I now have control of this incident’ / ‘You have control’). r. During a period of restraint the techniques being applied must be frequently reviewed with the aim to safely remove all forms of physical restraint in the shortest time practical. s. The Controller must have the authority to order the alteration or release of any of the restraint hold(s). Medical t. In some environments the specific health risks of detainees may be known, in other environments they will not be known. All approved restraint techniques must take into account the possibility that underlying disease(s) may render an individual more susceptible to adverse effects and possibly death. v. These assessments of vital signs must be repeated frequently throughout the period of restraint and the results made known to the Controller. Medical advice must be obtained if any concerns are expressed. w. If the restraint is a planned intervention in an institution with trained health care staff then they must be present throughout the period of restraint. Governance x. All episodes of restraint should be video recorded if at all possible. y. Detailed and accurate records of all incidents of restraint must be maintained and analysed locally and centrally. These data should be used to review techniques and practices and to inform staff appraisals, training and development. z. Debriefing procedures must be established and followed for all those involved (including if possible the detainee). If three or more officers are involved in any single episode of restraint there must be a formal face to face debriefing procedure by a trained member of staff. u. The vital signs (Airways, Breathing, Circulation) of the restrained individual must be assessed as soon as possible after the commencement of restraint by a member of the team nominated to do so by the Controller. 59