Restraint Application

RESTRAINT APPLICATION

• Used only when other, less restrictive, measures prove ineffective in protecting the patient and others from harm.
• Soft Restraints – limit movement (to prevent the confused, disoriented, or combative patient from injuring himself or others.
• Vest and Belt restraints – permit full movement of arms and legs (to prevent falls from bed or a chair.)
• Limb restraints – allow only slight limb motion (to prevent the patient from removing supportive equipment (e.g. I.V. lines, indwelling catheters, NGTs, etc).
• Mitts – prevent the patient from removing supportive equipment, scratching rashes or sores, and injuring himself or others.
• Body restraints – immobilize al or most of the body (to control the combative or hysterical patient.

When to use Leather Restraints?

ü When soft restraints aren’t sufficient

ü When sedation is dangerous or ineffective

*Duration of Leather restraint use is governed by state law and facility policy

Applied to:

ü All limbs (4-point restraints)

ü One arm and one leg (2-point restraints)

*Depending on the patient’s behavior

NOTE!!!

ü Use restraints cautiously in patients prone to seizures (increase the risk of fracture and trauma)

ü Restraints shouldn’t be applied directly over wounds or I.V. catheters (can cause irritation and restrict blood flow)

ü Use vest restraint cautiously in patients with heart failure or a respiratory disorder (can tighten with movement, further limiting circulation and respiratory function)

Equipments needed:

Soft Restraints

• Vest belt
• Limb or body restraints or mitts, as needed
• Gauze pads
• Washcloths if needed

Leather restraints

• Two wrist and two ankle leather restraints
• Four straps
• Key
• Large gauze pads to cushion each extremity

Preparation

1. Make sure the restraints are the correct size and weight as a guide BEFORE entering the patient’s room. (if leather restraints will be used, check if the straps are unlocked and the keys fits the locks.)
2. Use child restraints for a child who may be too small for standard restraints.

Procedures

1. Obtain a doctors order for the restraint

*Doctors order must be time limited

Age Range	Limited Time
Adults	4 hours
Children & Adolescents ages 9-17	2 hours
Under age 9	1 hour

*Original order may be renewed only for a total of 24 hours.

*After the original order expires, doctor must see and evaluate the patient before a new order can be written.

2. If necessary, enlist the help of several coworkers and organize their effort before entering the patients room, giving each person a specific task; for example, one person explains the procedure to the patient and applies the restraints while the others immobilize the patients arms and legs.

3. Inform the patient of the procedures (tell what you’re going to do, describe the restraints to the patient and assure the patient that they are used to protect him/her from injury , rather than to punish him/her.