2. Objectives
• Review NAEMS new policy on use of
restraints.
• Determine when/when not to use restraints
• Review different techniques to avoid using
restraints.
• Review standards for documentation when
restraint’s are used.
3. NAEMS Restraint Policy
In 2016 NAEMS Operations Staff developed a
policy regarding the use of physical restraint
after an incident involving an NAEMS staff
member took place.
To protect staff, as well as patients, the policy
was developed and will go in affect as of tonight.
4. NAEMS Restraint Policy
If no officer is present and restraints are needed;
- Crew members must call for assistance. This meaning a
police response (expedited if needed), Assistance from another
crew, or med control for possible sedation orders.
- IF needed, Crew members shall remove themselves from
the situation. Reminder, NEVER block a path of egress as it
could hinder your safety.
- Restraints must be used in accordance with FLREMSC
and State Protocols.
7. NAEMS Restraint Policy
• If an individual becomes aggressive during
transport, The driver shall immediately pull over,
and request a police response to their location. If
the individual attempts to remove themselves
from the ambulance the crew shall allow that
individual to do so. Crew members shall advise
dispatch of direction of travel, and description of
individual. If the crew members are unable to
calm patient, they shall remove themselves from
ambulance, making sure to take the keys out of
the ignition.
8. NAEMS Restraint Policy
• At the hospital:
– Crew members who placed the restraints shall remove
the restraints. Be sure the presence of Police or
Hospital Security prior to doing so. Also, do not be
hesitant to ask for Physician to order sedation prior to
moving them from your stretcher to hospital bed.
– If the restraints were placed by Police, EMS shall
utilize the “Hands off” Approach and allow the Officer
and Hospital Security to remove the restraints. If for
any reason Law Enforcement, Hospital Staff, Or
Security appears to needs emergent assistance, they
must ask prior to NAEMS staff assisting.
9. NAEMS Restraint Policy
If for any reason Police need assistance restraining
an individual, they must ask for assistance prior to
NAEMS staff assisting them. NAEMS staff shall
then document the name of the officer asking for
assistance in his/her PCR.
If NAEMS staff finds themselves in danger, they
shall use any means necessary to remove themselves
from the situation. At no time shall NAEMS staff
prolong an altercation with any individual.
10. NAEMS Restraint Policy
• All crew members must complete an incident
report on EMS charts following use of
restraints. A critique involving Operations
Staff will take place if deemed necessary. If an
NAEMS member is injured, or believes
excessive force was used by any personnel
involved in the restraint process, that person
must contact Operations Staff
IMMEDIATELY!
11. NAEMS Restraint Policy
• NOTE: NAEMS Operations Staff does understand that
there will be extenuating circumstances where this
policy may not be followed. If this occurs you must
contact a member of the Operations Staff Immediately.
NAEMS Strives to provide excellent and
compassionate care to all patients. Avoidable injury to
a patient during the restraint process will not be
tolerated. With that being said, we also take the safety
of our members very seriously. We all must do our best
to maintain a professional and compassionate attitude at
all times, and we must keep ourselves, our partners, and
our patients safe.
12. When/When Not to use physical
Restraints
• A 27 year old male who is suicidal, speaking to
ems in an aggressive manner, stating he will
hurt anyone who tries to help him. Becomes
even more agitated when ems tries to talk to
him.
• Restraint or No Restraints? What are the steps you’d
take?
13. When/When not to use physical
restraints
• 50 Year old female feeling depressed. Has
admitted to using drugs. Appears anxious.
Patient is screaming when you arrive.
• Restraints or no Restraints? What are the steps you’d
take?
14. Documentation Standards
• Follow all Documentation Standards already set forth
by the QA/QI Department.
• Document the time physical restraints were applied and
removed, what type of restraint was used (ie Sheet,
Cravats, handcuffs, ect)
• If patient is sedated, ALS Providers must document as
they would with any other medication administration.
• If patient is restrained by an Officer, The Officers name
must be documented in the EMS Chart. Also note that
if a patient is restrained using handcuffs, it must be with
his/her hands in the front, and the officer must ride in
the ambulance to the hospital.
