This document discusses the use of restraints for infants and children in medical settings. It defines restraints as devices that limit freedom of movement and notes they should only be used when necessary, never as a substitute for observation. Common types of restraints are described for different purposes like immobilizing extremities during procedures. Risks of restraints include physiological and psychological effects from prolonged immobility. Guidelines are provided for safe and appropriate use of restraints.

2. •A device which limits or
prevents freedom of
movement”.

3. • All infants and children have physiologic and
psychological needs to be mobile OR movement
• Prolonged immobility of children may result in
physiological loss of muscular strength and
flexibility. It may also affect the physiologic
functioning of the body in other way, such as
influencing respiratory volume and peripheral
circulation.
• Psychologically, long prolonged period of
restraint may result in the child’s inability to
develop motor and psychological skills owing to
a lack of motor and sensory contact with the

4. • 1)To limit the child’s movements during
procedure that may harm or injure the
baby.
• 2)To provide constant immobilization.
• 3)To provide maximum human contact
by using hand restraints.
• 4)To facilitate examination of child or a
procedure.
• 5)To ensure child’s safety and comfort.

5. • Used only when necessary and never
substitute for observation.
• Cannot be used on continuous bases.
• If used, reason should be specified and
explained to child and parents.
• Checked frequently to know not causing any
side effects.
• Any required knot should be tied in a manner
that permits quick release.
• Immobile child should be replaced the lost

6. 1.Mummy Restraints
2.Jacket Restraints
3.ElbowRestraints
4.Extremity Restraints
5.Abdominal Restraints
6.Crib withDomeRestraints

7. • Mummy restraint and modified mummy
restraints (Swaddle)
• Jacket restraint
• Elbow restraint
• Arm and leg restraint--Splints
• Extremity restraint(Clove hitch restraint)
• Crib and Crib with dome
• Mittens
• Papoos
• Abdominal binders(restraints)
• Bed cradle/ Bed with side rails

8. • PURPOSE
• To Immobilize of arms & legs for long
period of time.
• During Examination & Treatment of
head & neck
• During puncture of jugular vein
• During gastric gavage & lavage
• Modified mummy restrain may be used when the child’s
chest to be examine

12. • PURPOSE
• To help of the baby remain flat in bed in a supine
position
• To prevent of the baby falling from high chair
• To prevent of the baby up down on cribs
Chance of strangulation with jacket
restraints

14. • Disadvantage/Danger:-
• Use of a jacket restraint is that of
strangulation through pressure of a
restraint that has slipped out of place and
encircled a child’s neck.
• Age group:- Infant and toddler

15. • PURPOSE
• To keep of the elbow in extended position so
infant can not reach the face
after the surgery of the child’s face & head
such as cleft palate repair
• During in Eczema & skin disorder
• When introduce of the scalp vein

17. • Purpose
• To immobilize one or more extremities
• same as elbow restraint
• Other points :
• Applying on wrist or ankle
• 2 inch wide gauze bandage and make
figure of 8 then apply on the extremities
• In these restraint chance to cutting of
circulation so restrained extremities should
be examine for coldness and discoloration

20. • Uses:-
• To keep one or both extremity restrained or
limited in motion.
• Age group:- Neonate/infant/toddler/pre-
schoolers
• It must be padded to prevent undue pressure,
constriction or tissue injury and the extremity
must be observed frequently for signs of
irritation or impaired circulation. The ends of the
restraints are never tied to the side rails,
because lowering of the rail will disturb the
extremity , frequently with a jerk that may hurt or

22. • If the infant or toddler is capable of
climbing over the crib sides, a crib net or
plastic dome may be used to keep the
child safely in the bed
• Crib net should be tied to the frame. The
knot used must be of the type that can
be untied quickly in case of an
emergency

25. • Used for infants to prevent self injury
by hands in case of burns, facial injury
or operations, eczema of the face or
body.
• Mitten can be made wrapping the
child’s hand in gauze or with a little
bag putting over the baby’s hand and
tie it on at the wrist.
• Age group:-Neonate/infant

28. • Specially used in procedures like
exchange blood transfusion, head, chest
and abdomen.
• A Papoose Board is a device commonly
used to immobilize children for dental
work, blood-drawing, and minor medical
procedures.
• The child is placed on a flat board and
wide fabric straps are wrapped around the
upper body, middle body, and legs.

31. • This holds the infant in supine position
on the bed. It must not be applied so
securely that respiratory movements
of the abdomen are inhibited.
• Age group:- Infant/toddler/pre-
schooler

32. • PURPOSE
• To maintain supine position
• Other points :
• Keep in mind that child respiratory movement
of the abdomen are not inhibited

34. • A small low bed for an infant or a younger
child must have high side rails as a
restraint, to prevent falling from the bed.
• Age group:- Infant/toddler/younger child

36. • CAR SEAT
• Car seat / seat belt can be
considered as a restraint.

37. • Child too distressed despite adequate
preparation
• Older children with several behavioural
problems
• Informed refusal by the parents/ gurdian/ child
• Pre existing medical condition or physical
disability/ limitation
• History of sexual or physical abuse that
would place the child at greater psychological
risk

38. • Injury to the brachial plexus
• Sore or gangrene
• Exhaustion
• Loss of energy
• Dislike for the hospital and health team
members
• Physiologic loss of muscular strength and
flexibility
• Psychological hazards and inability to
motor and psychosocial skills
• Difficulty in developing own body image

39. • The reason for applying restraints must be
explained to both the child and the parents. This
may be done through the application of restraints
to a doll or a stuffed animal .
• While applying the restraint and periodically
during the period of restraint, the nurse should
talk soothingly to the child to provide stimulation
and diversion.

40. • Sufficient padding must be used under
extremity restraints to prevent skin
irritation.
• The ties on restraints should be attached
to the crib frame instead of to the crib rails
to prevent traction on the restraint or injury
to the child when the crib rail is raised and
lowered.
• Restraints must be checked every 15 to
30 minutes to determine whether they are
achieving their purpose and whether they
are constricting the respirations or
circulation in any way.

41. • Explain to parents the need,alternatives,positive and negative
aspects of restraints and consequences of not using restraints.
• Use the parents’ assistance to obtain the child’s cooperation.
• Attempt to find an alternative to using restraints. Some options
are-
• Increased supervision of child by hospital personnel or parents.
• Modifications of the environment
• Redirection of the child
• Diversionary activities such as television/radio
• Preparing the child for a procedure with a simple explanation if
developmentally appropriate.

42. • Restraint is necessary at
time to examination, To
facilate procedure &
treatment, To protect infant
from harm or Injury
• But should not for close
observation

43.  Explain the restraints purpose
both of parents & child. This
restraint explain by the
procedure & Demonstration on
doll or etc..
 Stimulate the baby During
restraints or give diversion so
baby do not feel helpless &
loneliness.
 Restraint put effectively so
respiration and circulation dose
not interference.
 Sufficient padding must be
used under extremity restraints

44.  The ties on restraint should ne attached
to the crib frame instead of to the crib
rails to prevent traction on the restraint or
injury to the child when the crib rail is
raised and lowered.
 Restraint must be check every 15 to 30
minute for our purpose and respiration
and circulation
 Periodically, at least every 2 hourly the
child should be removed from the
restraint
 Before the restraint are reapplied, the
child’s position should be changed to
improve physiologic function.