Which is the best knot to use when applying a patient restraint?
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Contributed by Tammy J. Toney-Butler, AS, RN, CEN, TCRN, CPEN/John Roberts, BSN, RN
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A half bow knot is secure enough for restraints, but it can be quickly and easily released if necessary.
Most institutions want a restraint free policy but when necessary to utilize for patient and staff safety, certain guidelines and protocols exist. Documentation and ordering will be hospital specific.
Never tie a restraint to a side rail and avoid tying at the end of the bed. A quick release knot is ideal in case a patient has a seizure or emergency condition that would warrant prompt removal of restraint.
Mechanical restraints or locked restraints require more frequent monitoring and documentation than soft restraints. Refer to your institutions policies and procedures on the use, ordering, monitoring and documentation of this type of restraint. Mechanical restraint use is often restricted to critical care or emergency departments. Chemical sedation may be required.
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