Restraining children for painful procedures

How, and when, can I restrain a patient?

“…28 Gray suggests that the cumulative effect of the United Nations convention and UK legislation in conjunction with societal changes in the perception of children has resulted in restraint being perceived unfavourably and as constituting outdated practice. 29 Pederson and Harbaugh stated that lack of knowledge and lack of time to employ distraction techniques were reasons cited for the use of restraint, 30 and the survey of paediatric nurses in England carried out by Robinson and Collier 31 suggested that restraint was perceived as a rapid and easy method of ensuring that procedures were completed quickly and safely, although it was also identified by over 69% of respondents as a leading cause of distress to children.…”

“…Collins proposed that the use of restraint is indicative of a lack of understanding of the value of distraction and relaxation techniques in reducing pain and distress in children undergoing procedures. 28 Gay described the use, in an English accident and emergency department, of dolls to provide a visual demonstration of procedures to children. 32 The opportunity, where possible, to handle real or modified equipment was also found to be useful as a strategy for reducing anxiety in children.…”

“…Collins identified the need for nurses to be better educated in alternatives to restraint and in restraint techniques, but acknowledged, however, that it is problematic when a child appears to understand what is proposed, but refuses to cooperate. 28 Collins acknowledged the conflict between violating the child's human rights by employing restraint and the desire to do what is perceived to be in the best interest of the child. 28 Collins also found that the amount of training that nurses receive in this area of practice is variable and that there is a need for them to receive better education in restraint techniques, should such measures be required.…”

“…28 Collins acknowledged the conflict between violating the child's human rights by employing restraint and the desire to do what is perceived to be in the best interest of the child. 28 Collins also found that the amount of training that nurses receive in this area of practice is variable and that there is a need for them to receive better education in restraint techniques, should such measures be required. 28 Gray discusses the use of conscious sedation in children.…”

“…28 Collins also found that the amount of training that nurses receive in this area of practice is variable and that there is a need for them to receive better education in restraint techniques, should such measures be required. 28 Gray discusses the use of conscious sedation in children. 29 He points out that ketamine has been used by emergency room clinicians in the USA for more than 20 years, but that its use remains controversial in the UK.…”