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Prepare and Apply Restraints - Psychosocial Issues

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NOTE:
Shoulder dislocations are especially problematic if the patient is combative
during the application of the restraints or has a grand mal seizure while
restrained.
3-4.
PREPARE AND APPLY RESTRAINTS
a. Check the Doctor's Orders or the Therapeutic Documentation Care Plan (Non-
medications). Verify restraints or follow your supervisor's directive indicating that the
patient is to be restrained and the type of restraining equipment to be employed.
NOTE:
In a field environment, the need for restraints may be your own decision,
especially in the absence of a senior medical specialist or physician.
b. Perform a patient care hand wash.
c. Gather equipment.
(1)  Commercial restraints. This group includes limb holders or wrist type
("soft restraints"), body, jacket, elbow, leather (has a buckle with a locking device which
requires a key to unlock), and papoose board or wrap (used for children).
(2)  Improvised wrist and ankle restraints. This group includes abdominal
(ABD) pads, washcloths, gauze sponges, sponge rubber roller gauze, and elastic
bandages.
d. Verify the patient to be restrained.
NOTE:
In case of emergency, paragraph 3-4d will be omitted.
e. Explain the procedure to the patient. Speak in a quiet, calm, reassuring voice
and explain to the patient why the restraints are being applied in order to gain his
cooperation. It may be necessary to repeat the explanation at frequent intervals,
especially if the patient has been medicated with mind altering drugs or is confused. It is
also essential that the patient's family and friends understand as well.
NOTE:
If the patient is agitated or combative, keep the restraints out of his vision until
he is in a position to be restrained.
f. Provide privacy for the patient. Place a screen/curtain around the patient's bed
or close the patient's room door. Provide privacy to avoid upsetting other patients or
causing embarrassment to the patient being restrained.
MD0549
3-4



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