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An acceptable minimum of trained personnel would start at six—four to five for control, with an additional two to three for restraint. More often than not, you will have three on-scene with medics responding. If the patient becomes violent, egress is unsafe, and de-escalation fails, attempt to control the patient with the resources at hand. With training, three personnel can acquire and maintain control long enough for incoming units to respond for aid. This is a controlled environment in a classroom. Do note how the officer(white shirt) is positioned to communicate with his crew and monitor the patient, calm deliberate communication is essential. It is not by accident that the firefighter at the feet is watching the officer, what would happen if the patient got loose? If the firefighter at the feet is facing the wrong way there would be little he could do to prepare for the patient coming at him. The firefighters in this photo have the bulk of their weight focused on the appendage they are controlling.

Fire Engineering Sep 2008: Tactics For Combative Patients, Author: Michael W. Weaver