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Safe Patient Physical Restraint Cheat Sheet by


Physical or chemical restraints should only be utilized when a patient is
potent­ially a danger to self and/or others. Restraint is not to be used on indivi­duals refusing treatment unless they are legally or mentally incapable of providing consent (and are thus treated by implied consent) or under a police or mental health (depending upon the jurisd­iction) hold.

Physical Restraint Guidelines

Use the least restri­ctive method required to accomplish necessary patient care andensure safe transp­ort­ation:
1. Do not endanger yourself or your crew
2. If law enforc­ement or additional personnel are likely to be needed, call for assistance prior to attempting restraint procedures
3. Soft restraints are usually sufficient to secure extrem­ities; plastic ties or other hard restraints should only be used when all other altern­atives are inadequate to ensure safety. Consult with your local medical authority for any regula­tions related to the use of specific restraint devices.
4. Avoid applying any pressure to or obstru­cting the airway, or affixing limb restraints that inhibit distal circul­ation.
5. NEVER restrain a patient in the prone position; it becomes impossible to monitor and/or protect the airway.
6. Explain to the patient why he/or she is being restra­ined.
7. Once restraints have been applied, NEVER engage in “negot­iation” with the patient for their release, or release them if the patient has become “compl­iant”. The risk for harm that you felt was originally present has not changed.
8. Whenever locked devices are used, by anyone, keys must be immedi­ately at the patient’s side at all times. Consult with your local medical authority for any regula­tions related to the use and ongoing monitoring of locking restraint devices.

Restraint Intrus­iveness

Sugges­tions for maximum physical restraint

Ensure sufficient personnel are present: USE LAW ENFORC­EMENT ASSISTANCE WHEN AVAILABLE.
Place patient on long backboard
If necessary, use spinal precau­tions to control violent head or body movements.
Secure all extrem­ities to the backboard. Try to restrain lower extrem­ities around the ankles first.
Secure the backboard onto gurney for transport using additional
straps; avoid restri­cting the wheeled carriage.

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