Medical Restraint - Types of Medical Restraints

Types of Medical Restraints

There are many types of medical restraint:

• Four-point restraints, fabric body holders, straitjackets are typically only used temporarily during psychiatric emergencies.
• Lap and wheelchair belts, or trays that clip across the front of a wheelchair so that the user can't fall out easily, may be used regularly by patients with neurological disorders which affect balance and movement.
• All four side rails being in the upright position on a bed can be consider a restraint.
• Safety vests and jackets can be placed on a patient like any other vest garment. They typically have a long strap at each end that can be tied behind a chair in order to prevent the patient from getting out of the chair, or to the sides of a bed to keep the patient in bed. Posey vests are commonly used with elderly patients who are at risk of serious injury from falling.
• Limb restraints are used to prevent activity in various limbs. They are wrapped around the wrists or ankles, and tied to the side of a bed, to prevent patients from harming themselves or others by preventing the patients from using their arms or legs.
• Mittens to prevent scratching are common for newborns, but may also be used on psychiatric patients or patients who manage to use their hands to undo limb restraints.
• A Papoose board can be used for babies and young children.
• Chemical restraints are drugs that are administered to restrict the freedom of movement or to sedate a patient. Their use is heavily restricted.
• A number of private national and regional companies teach physical (non-mechanical) restraint techniques for companies and agencies that care for or have custody of people who might become aggressive. The strategies vary widely, with many based on police or martial art pain-compliance techniques, with others using only pain-free techniques. Most also emphasize verbal de-escalation and defusing skills before using any physical skills. A non-inclusive list:

• PCM (Professional Crisis Management) from the Professional Crisis Management Association (www.pcma.com)
• The Mandt System.
• NAPPI (Non Abusive Psychological and Physical Intervention).
• NVCI (Non-Violent Crisis Intervention) techniques from CPI (Crisis Prevention Institute).
• ProACT (Professional Assault Crisis Training).
• TCI (Therapeutic Crisis Intervention).