This content clearly explains what is a restraint, types, purpose, indications for using, criteria of using, contraindications & nursing care of a patient on restraint.
2. ● A physical restraint is a human, mechanical or
physical device that is used with or without the
patient’s permission to restrict his or her
freedom of movement or normal access to a
person’s body & is not a usual part of treatment
plans indicated by the person’s conditions or
symptoms.
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2
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GUIDELINES
FOR USING
RESTRAINTS
ONLY TO ENSURE THE PHYSICAL
SAFETY OF THE PATIENT OR OTHER
RESIDENTS
WHEN LESS RESTRICTIVE
INTERVENTIONS ARE NOT
SUCCESSFUL
ONLY ON THE WRITTEN ORDER OF
A PHYSICIAN
4. TYPES OF RESTRAINTS
1. Physical restraints
2. Chemical restraints
PHYSICAL RESTRAINTS
● Belt restraints : device that secures the client to
bed or stretcher. Apply over the clothes or
gown. Avoid placing belt across the chest or too
tightly across the abdomen
● Extremity restraints (ankle or wrist ) : restraint
designed to immobilize one or all extremities. a
simple wrist restraint is called as a CLOVE
HITCH.
● Mitten restraints : thumbless mitten device to
restrain patient’s hands. Place hands , being
sure to bring end all the way up over the wrist.
5. ● Elbow restraint : piece of fabric
with slots in which tongue blades
are placed so that elbow joints
remains rigid
● Mummy restraint: open blanket or
sheet on bed or crib with one
corner folded toward centre. Place
child on blanket shoulders at fold
and feet toward opposite corner.
Controls movement of torso &
extremities.
13. CHEMICAL
RESTRAINTS
● It is a form of medical restraint in which a drug is used to
restrict the freedom or movement of a patient or in some
cases to sedate the patient.
● used in emergency, acute & psychiatric settings
● commonly used drugs are benzodiazipines, antipsychotic &
dissociative anesthetics.
● also termed as PSYCHOPHARMACOLOGIC AGENT,
PSYCHOTROPIC DRUG or THERAPEUTIC RESTRAINTS.
15. 11. Diminished muscle & bone tone
12. Fractures
13. Altered nutrition & hydration
14. Changes in mental status
15. Aspiration
16. CARE OF
PATIENT ON
RESTRAINTS
● Get informed consent from the
relatives before applying restraints.
● Restraint order is valid only for 24 hrs
● Reassess the patient for continued use
of restraints with the intent of
discontinuing restraint at the earliest
possible time
● Inspect patient for any injury, including
hazards of immobility
● Observe IV catheters, urinary catheters
& drainage tubing are in correct
position
● Provide appropriate sensory
stimulation & frequently re orient the
patient
17. ● Assess the consciousness & orientation,
oxygenation, skin integrity(redness, skin
irritation), circulation (pulse) , parasthesia
& change position of the patient every 2
hrs
● Remove restraints every 2 hrs & assess the
patient
● Record the time & date of assessments &
releases
● Record type & location of restraint & time
applied
● apply restraints smoothly & snugly
without obstructing blood circulation
● tie the restraints on the bed not to the side
rails
