Physical restraints in emergency medicine

Physical restraints in emergency medicine

Introduction

Violent and combative patients are normally stumbled upon in the emergency unit. Such patients might be brought to the emergency by the worried family members referred to the emergency department by other professionals of health care or moved by the personnel of emergency medical services or police for being a cause of public commotion. Such patients cause considerably management and diagnostic challenges to the technicians, nurses, physicians, and other personnel, endeavouring to care for them. The behaviour of a violent patient may be due to a number of causes counting in but not restrained to the metabolic disturbances, traumatic injury, substance abuse and withdrawal, and psychiatric illness. When the de-escalation approaches are useless in causing an agitated patient to cooperate, then the employment of chemical and physical restraints are required being taken into consideration. After the decision is taken for using the restraints, it is significant to pursue the policy of the hospital on the documentation and monitoring of the patient.

Physical Restraints

Physical restraints require being taken into consideration when the earlier endeavours for establishing trust and rapport, for establishing limitations, and for informing a patient regarding the outcomes of non-cooperation, have fallen short. The decision of ordering the physical restraints is intricate for the reason that complications may crop up and their usage may be considered as punishment or coercion rather than an ultimate remedy for ensuring safety. The signs of restraining a patient count in; preventing serious disruption or damage to the environment, preventing harm to caregivers and other staff, preventing harm to other patients, and preventing harm to oneself. Physical restraints may be useful in permitting the physician for performing a medically specified examination in a patient with distorted mental state or when the specified medicines require being administered safely (Bisantz & Wears, 2009).

Despite, retraining patients may be dicey, suitable usage when required might be less dicey compared to not averting the out of control conduct of the patient that may result in deferred treatment of the injury or the patient to the staff of the emergency department. Physical restraints must not ever be employed for the convenience of the staff. All institutions must have a comprehensive protocol for the employment of restraints. Such a protocol must figure out the members of a restraint team and also the way to stimulate the team. Every member of the restraint team must be suitably familiar with and trained for the process of restraining. The restraining team must have to the minimum five members, counting in a nominated leader for explaining the procedure to the patient in a lucid and comprehensive manner. Such a display of force alone may at times bring about finer conduct from a violent patient. For preventing the lawsuits, is possible, minimum one member of the team must be a female, particularly when a female has to be restrained (Hill & Petit, 2000).

Prior to getting into the room of a patient and starting off with the procedure of restraining, ...