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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Adult Lab Normals
Pediatric Lab Normals
Restraint use among selected hospitalized elderly patients in Cairo, Egypt., Eltaliawi AG,El-Shinawi M,Comer A,Hamazah S,Hirshon JM,, BMC research notes, 2017 Nov 28 [PubMed]
Use of mechanical and pharmacological restraint over an eight-year period and its relation to clinical factors., Reitan SK,Helvik AS,Iversen V,, Nordic journal of psychiatry, 2018 Jan [PubMed]
Psychotropic Drug Use in Physically Restrained, Critically Ill Adults Receiving Mechanical Ventilation., Guenette M,Burry L,Cheung A,Farquharson T,Traille M,Mantas I,Mehta S,Rose L,, American journal of critical care : an official publication, American Association of Critical-Care Nurses, 2017 Sep [PubMed]
How to deal with violent and aggressive patients in acute medical settings., Harwood RH,, The journal of the Royal College of Physicians of Edinburgh, 2017 Jun [PubMed]
Involuntary care - capturing the experience of people with dementia in nursing homes. A concept mapping study., de Boer ME,Depla MFIA,Frederiks BJM,Negenman AA,Habraken JM,van Randeraad-van der Zee CH,Embregts PJCM,Hertogh CMPM,, Aging & mental health, 2018 Feb 7 [PubMed]
Restraint Use in Older Adults Receiving Home Care., Scheepmans K,Dierckx de Casterlé B,Paquay L,Van Gansbeke H,Milisen K,, Journal of the American Geriatrics Society, 2017 Aug [PubMed]
Delirium in the Intensive Care Unit., Arumugam S,El-Menyar A,Al-Hassani A,Strandvik G,Asim M,Mekkodithal A,Mudali I,Al-Thani H,, Journal of emergencies, trauma, and shock, 2017 Jan-Mar [PubMed]
State of Acute Agitation at Psychiatric Emergencies in Europe: The STAGE Study., San L,Marksteiner J,Zwanzger P,Figuero MA,Romero FT,Kyropoulos G,Peixoto AB,Chirita R,Boldeanu A,, Clinical practice and epidemiology in mental health : CP & EMH, 2016 [PubMed]
Use and avoidance of seclusion and restraint: consensus statement of the american association for emergency psychiatry project Beta seclusion and restraint workgroup., Knox DK,Holloman GH Jr,, The western journal of emergency medicine, 2012 Feb [PubMed]
Disruptive behaviour in the perioperative setting: a contemporary review., Villafranca A,Hamlin C,Enns S,Jacobsohn E,, Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2017 Feb [PubMed]