Clinical practice guidelines for the maintenance of patient physical safety in the intensive care unit: Use of restraining therapies—American College of Critical Care Medicine Task Force 2001–2002

Abstract

The task force developed nine recommendations with regard to the use of physical restraints and pharmacologic therapies to maintain patient safety in the intensive care unit.

Use of Physical Restraints in Dutch Intensive Care Units: A Prospective Multicenter Study

“…These findings contrast with the guidelines of the Society of Critical Care Medicine on the use of restraining therapies, in which chemical restraint (or sedation) is mentioned as an alternative to physical restraint. 1,12 However, the guidelines were published in 2003, and since www.ajcconline.org then several investigators 24,25 have reported harmful effects of sedation. We think that chemical restraint should be used with caution, and in accordance with current sedation guidelines.…”

“…Participation of a patient's visiting relatives in the healing process may help the patient and the relatives regain some control over the situation, and therefore reduce the use of physical restraint. 1 Use of "boxing gloves" and use of "splints" are different restraining methods that allow patients to move their limbs but prevent refined motor functions such as grasping a tube or catheter. Finally, securing catheters and endotracheal tubes may decrease the concern that a patient would remove these devices and thus reduce the use of physical restraint.…”

“…7,8 Although physical restraint is intended to prevent accidental removal of devices, it may actually increase agitation and accidental self-removal of endotracheal tubes. 9 The Society of Critical Care Medicine has created guidelines 1 for the use of restraining therapies to decrease inappropriate use of physical restraint. The scope of the use of physical restraint is still unclear; however; frequencies between 0% and 100% have been reported.…”

“…2015;24:488-495) F or patients who are in the intensive care unit (ICU), physical restraint (ie, the mechanical restriction of movements) can be used with the intention to prevent accidental removal of endotracheal tubes, catheters, and drains and to allow essential treatment. 1 Physical restraint can be used alone or in combination with chemical restraint (ie, sedation). 2 The effectiveness of physical restraint has never been studied in a randomized clinical trial, and evidence of harmful effects associated with physical restraint is increasing.…”

Use of Physical Restraints in Neurosurgery: Guide for a Good Practice

“…Canada and British Columbia have legislations (Currie, 1997). While the UK, however, does not accept physical restraint use at all, it is common in the US, Australia, and Europe (Maccioli et al, 2003;Royal College of Nursing, 2004;Van Norman & Palmer, 2001). Nurses and scientists from other disciplines tried to agree on physical restraint use starting in 1988 no consensus reached yet on its use in hospitals (Bower & McCullough, 2000).…”