High levels of intoxication can lead to tripping and falling down, and fatal accidents were reported due to asphyxia.

The state medical examiner’s office ruled Otieno’s death a homicide, finding that he died of “positional and mechanical asphyxia with restraints.”

Nearly all states have a Peace Officer Standards and Training agency that sets out what must be taught, so AP asked each commission whether it requires instruction on positional asphyxia.

Among the states that responded, 10 said they did not require positional asphyxia training and 20 states said they do include that training.

These results highlight the need for early genetic testing in children with cerebral palsy, especially those with risk factors like birth asphyxia, to ensure they receive the right medical care and treatment.