The extent of the problem of deaths in custody due to positional asphyxia caused by hog-tying is unknown, because the information on the problem is mostly anecdotal. However, the number of such deaths may be greater than the recorded number due to misdiagnosis by coroners who are unaware of the phenomenon. Jail officers use restraints for three general reasons: to protect themselves, to protect the prisoner, and to protect others nearby. A case might be made to continue the use of hog-tying if it were the only method of restraining an unruly prisoner. However, many jails are using better ways to restrain and control prisoners. They use measures such as restraint chairs and restraint boards and have prohibited the use of hog-tying. Positional asphyxia is a reality, and correctional officials should be aware of how hog-tying can lead to death. This method should be eliminated, and correctional personnel should receive training on how to use other approaches. Lists of 6 references and 3 other sources