Published:December 17, 2022DOI:



      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.


      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.


      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.


      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.


      In healthy adult subjects, there were no statistically or clinically significant differences in ventilatory or circulatory parameters while wearing the saturated spit restraint.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. Gore WD, Barnett MR. San Diego County Sheriff's Department Use of Force Statistical Report 2019-2020. Available at: Accessed July 31, 2021.

      2. Gore WD, Barnett MR. San Diego County Sheriff's Department Use of Force Statistical Report 2018-2019. Available at: Accessed July 31, 2021.

      3. Gore WD, Elvin M. San Diego County Sheriff's Department Use of Force Statistical Report 2015-2016. Available at: Accessed July 31, 2021.

      4. Corrigan P. The case against the use of spit hoods in response to Covid-19. Amnesty International UK/Blogs, 5 November 2020. Available at: Accessed July 31, 2021.

        • Sisak M
        • Balsamo M.
        Police use of spit hoods scrutinized after Black man's death.
        AP News, September 4, 2020 (Available at) (Accessed July 31, 2021)
        • Watkins A.
        What are ‘spit hoods,’ and why do the police use them?.
        The New York Times, September 3, 2020 (Available at) (Accessed July 31, 2021)
      5. Chappell B. No charges against Tucson police officers in death of Carlos Ingram-Lopez. NPR, September 22, 2020. Available at: Accessed July 31, 2021.

        • Felton R.
        Lawsuit over Michigan man's death in jail focuses on officers’ use of ’spit hood’.
        RT [Russia Today] News, 11 January 2016 (Available at) (Accessed July 31, 2021)
        • Lutz M
        • Sloane CM
        • Castillo EM
        • et al.
        Physiological effects of a spit sock.
        Am J Emerg Med. 2019; 37 (Available atAccessed December 27, 2022): 291-293
        • Marigold O
        • Castillo EM
        • Sloane C
        • et al.
        Further study on the physiological effects of an alternative spit mask.
        J Forensic Leg Med. 2020; 72101945
        • Park M-S
        • Chung J-W
        • Kim Y-K
        • Chung S-C
        • Kho H-S.
        Viscosity and wettability of animal mucin solutions and human saliva.
        Oral Dis. 2007; 13: 181-186
        • Bellware K.
        Daniel Prude's death highlights dangers of ‘spit hoods’ and calls for regulation.
        Washington Post, September 5, 2020 (Available at) (Accessed August 7, 2021)
        • Daniels J
        (ABC 10), Thomas C. Family of 12-year-old in spit hood incident files federal lawsuit against Sacramento.
        ABC. 24 April 2020; 10 (Available at) (Accessed July 31, 2021)