A common pattern of bizarre, violent behavior or frenzied hyperactivity prior to or during the police contact emerges in these seven and other reported cases of sudden in-custody deaths. An analysis of sudden in-custody deaths reported by 142 law enforcement agencies responding to a 1992 survey showed that 64 percent of the agencies used some form of leg restraint and 43 reported the use of the hogtie position. Additionally, 36 agencies noted they had developed special procedures for dealing with arrestees who displayed biazarre or violent behavior. A review of available literature provides information relating to the potential lethal effect of improperly applied neck holds as well as the phenomena of "positional asphyxia" and "cocaine psychosis" or "excited delirium." Positional asphyxia occurs when the position of the body interferes with respiration and results in asphyxia. Excited delirium is a contributing factor to positional asphyxia. A task force offers guidelines for the use of the carotid restraint hold when restraining individuals who are actively resisting arrest or who are assaultive. 2 references