The document provides an overview of child health nursing procedures related to the use of restraints, defining them as protective devices to minimize movement and enhance safety. It details various types of restraints, including mummy, elbow and knee, and jacket restraints, along with their purposes and application techniques. The document emphasizes the nurse's responsibilities in ensuring safety, comfort, and regular monitoring while using restraints in pediatric care.

1. CHILD HEALTH NURSING - I
NURSING PROCEDURE ON
“RESTRAINT”
Mr. Sachin Sharma
Assistant Professor
Child Health Nursing Department
SEMESTER-V UNIT-1

2. OBJECTIVES
• Definition
• Purpose
• Articles Needed
• General Principles
• Types Of Restraining
• Nurses Responsibility
• Conclusion

3. DEFINITION:
• Restraints are protective and mechanical devices
which are used to minimize the movements and
protects the child from injury. These restraints are
made up of linen, canvas, plastic, metal or wood.

4. PURPOSES:
1. To carry out the physical examination
2. To provide safety to the child
3. To complete the diagnostic and therapeutic procedure
4. To protect the child from injury
5. To maintain the child in prescribed position
6. To reduce the discomfort of child during some test and
procedures like specimen collection.

5. ARTICLES NEEDED
• Baby blanket or draw sheet
• ‘4 ‘bandage for clove hitch knot
• Cotton pads
• Restraint cloth with pocket
• Wooden or plastic strip to keep in pocket for elbow restraint.
• Scissors to cut the bandage
• Jacket for jacket restraint
• Adhesive tape to fix the bandage

6. GENERAL PRINCIPLES:
• Always select the safe and appropriate restraint.
• Restraint should not be too tight. It should not interfere with the
normal circulation.
• Use appropriate cotton pad for maintaining the comfort of child
• Explain the restraint and it is important that the child should be able to
understand
• Always maintain comfort to the child and maintain body alignment
• Open the restraint knot when the side rails are raised to prevent
traction
• Observe restraint every 20-30minute to prevent any complication
• Do not give too much tight knot. It should be easily releasable
• Do not do purposeless restraining
• Do the recording and reporting

7. TYPES OF RESTRAINING:
Mummy restraint
Elbow and knee restraint
Jacket restraint
Extremity restraint (clove hitch
knot)
Crib net restraint
Side rail
Safety belt
Finger restraint
Abdominal restraint

8. MUMMY RESTRAINT

9. PURPOSE
• Mummy restraint is used for the children to restrict the movement of
limbs. It is used for examination procedure and treatment of head,
neck and face.

10. PROCEDURE FOR MUMMY RESTRAINT
• Take a blanket or draw sheet and spread it over the bed or table.
• Place the baby on back side keep one hand of baby near the body and
wrap the baby’s body by holding the corner of sheet and tuck it under
the body in opposite side.
• Place another hand near the body and wrap the child body by holding
another corner of sheet and tuck it.
• Take the rounded sheet at bottom near the leg and fold towards the
chest and tuck at upper level of sheet it restrict all the extremities.

11. ELBOW AND KNEE RESTRAINT

12. PURPOSE
• Elbow and knee restraint is used to control the flexion of elbow and
knee.
PROCEDURE
• keep the wooden or plastic strip in pocket of cloth. These pockets are
vertical.
• Place the cotton on elbow and knee and adjust it with central
location and tie the both side strips properly.
• The elbow restraints are used in case of face and head surgeries.
Eg;Cleft lip and cleft palate, scalp vein etc.

13. CLOVE HITCH KNOT RESTRAINT

14. PURPOSE
• To immobilize leg or arm
PROCEDURE
• Crepe bandage and 2inch wide gauze bandage. First apply the cotton pad
over the wrist, ankle to provide comfort.
• Prepare a figure of eight by the bandage and place it in the wrist or on
the ankle.
• Tie the bandage by knot.
• Knot should not be too tight or too loose.
• Child can remove the knot if it is too loose. Too tight can interfere in
blood circulation.
• The finger and toes should be checked for discoloration or any skin rash
etc.

15. How to tie a Clove Hitch knot

16. Step 1

17. Step 2

18. Step 3

19. Step 4

20. Step 5

21. Step 6

22. JACKET RESTRAINT

23. PURPOSE
• To prevent the child from fall and injury
PROCEDURE
• In this method a jacket made up of soft cloth and leather .
• This jacket has lace at the back and two long strips.
• The lace is tied at back and long strip tied at the side below the rail under
the mattress.
• Child can sit and sleep in supine position while wearing jacket it can
also use on chair.
• This restraint is used to avoid the child from climbing over side rail,
climbing out from chair, bed, cot etc. It prevents the child from fall and
injury.

24. CRIB NET RESTRAINT

25. CRIB NET RESTRAINT
• In this a net is used to cover the Childs cot net is attached to the cot
frame. This net restraint is used to prevent the children climbing
over the side rails of cot.
• In this net, when side rails are up the child can stand but cannot
climb over the side rails of cot. Inside the crib net, the child is totally
free to move, no movement is restricted. It mainly prevents the child
to climb and fall from the side rails of cot.

26. SIDE RAILS

27. SIDE RAILS
• These are available especially in children cot.
• The rails are made up of iron or steel.
• These can be raised whenever need arises and can be decreased, as
per convenience the main purpose of side rails are to prevent from
fall.

28. SAFETY BELTS

29. SAFETY BELTS
• These are made up of electrically non conductive materials.
• These belts are used on stretcher and operation tables to prevent the
children from falling.
• These belt go around the Childs waist and tied to the frame of bed
under the mattress.

30. FINGER RESTRAINT

31. FINGER RESTRAINT
• It can be completed by making a mitten.
• the mitten cover all fingers of a hand and restrict the movement of
finger.
• The hand can be wrapped by the gauze or hand can be put in a bag
like pouch and tie it properly at the wrist of child.
• Finger restraint is used in case of facial surgeries, burns, intravenous
infusion, any eczema of face and body part.
• keep the mitten soft and it should not interfere with circulation.

32. ABDOMINAL RESTRAINT

33. ABDOMINAL RESTRAINT
• This restraint is used to hold the infant in a supine position on the
bed.
• Abdominal restraint should not be too tight, so that it cannot
interfere with respiration and bowel movement.
• For this restraint use wide size wooden strips.
• Place the cotton pad appropriately to provide the proper comfort.

34. COMPLICATIONS
 It can interferes the child’s muscular development due to lack of
movement.
 If restraint is too tight, it causes obstruction in blood circulation,
tissue damage, redness, scar formation etc.
 Dislocation of the shoulder joint may occur if the child struggles
during application of arm restraint
 Hypostatic pneumonia due to immobility
 ischemia or nerve damage due to constrictive restraint
 Psychic injury to the child, the child feels that he /she punished
alternation in self body image.
 Disturbance in psycho social development.

35. NURSES RESPONSIBILITY
• Explain the reason for the restraint to the parent and child.
 Free movement facilitates growth and development.
 Adequate padding under wrist and ankle restraint essential to
prevent skin irritation.
 Good body alignment should be maintained.
 Any kind of restraint must be checked every 15 minute and
removed periodically.
 Regular monitoring and decision making trial inclusive of
ongoing review of the need for restrain.
 Meet the safety, comfort, psychological need inclusive of
nutrition and hydration.
• It is the responsibility of the nurse to assess the child behavior
and environment to promote the safety of child

36. CONCLUSION
• Restraints are protective and mechanical devices which are used to
minimize the movement and protect the child from injury. The
purpose of restraint is to provide safety to child and maintain child
in a prescribed position. There are various type of restraint used in
paediatric

37. THANK YOU