The document provides guidelines on the use of physical and chemical restraints in patients, detailing types such as belt, extremity, and elbow restraints, as well as medications used for sedation. It emphasizes the importance of patient safety, informed consent, and the need for regular assessment and reassessment to prevent complications. Additionally, it outlines the potential complications arising from restraint use, including pressure ulcers and changes in mental status.

1. RESTRAINTS

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.

3. 1
2
3
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.

6. EXTREMITY
RESTRAINTS
1. WRIST
RESTRAINTS

7. 2.ANKLE
RESTRAINTS

9. BELT RESTRAINTS

10. MITTEN
RESTRAINTS

11. MUMMY RESTRAINTS

12. JACKET RESTRAINTS

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.

14. COMPLICATIONS………
1. Pressure ulcer
2. Constipation
3. Pneumonia
4. Urinary & fecal
incontinence
5. Urinary retention
6. Contractures
7. Nerve damage
8. Circulatory impairment
9. Impaired skin integrity
10. Danger of suffocation

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