Review of the medical and legal literature on restraint chairs

Abstract

a b s t r a c tUse of restraint chairs by law enforcement for violent individuals has generated controversy and a source of litigation because of reported injuries and deaths of restrained subjects. The purpose of this study is to review the available medical and legal literature and to allow the development of evidence-based, best practice recommendations to inform the further development of restraint chair policies. This is a structured literature review of four databases, two medical and two legal. The medical review focus was on the restraint chair with additional review of materials regarding other restraint methods and options. The legal review focused on litigation cases involving the restraint chair.The review of the medical literature revealed 21 peer-reviewed studies investigating the physiological or psychological effects of using a restraint chair on humans or primates. Of these studies, 20 were performed on primates. The single human study revealed no clinically significant effects from the restraint chair on test subjects. The legal literature review revealed very few cases where the restraint chair was either a major or minor focus. The overall issues relating to the restraint chair cases involved deviations from set protocols and rarely involved issues with the chair itself.The available medical literature reveals that the restraint chair poses little to no medical risk. Additionally, when used appropriately, the restraint chair alone carries little legal liability. With proper monitoring and adherence to set protocols, the restraint chair is a safe and appropriate device for use in restraining violent individuals.

How Should Trainees Be Taught to Have Compassionate Intention When Force Is Necessary to Care Well for Patients?

“…These strategies may include offering clear and direct choices, using a calm tone of voice, and minimizing the length of time in restraints. 16 Additional educational opportunities include debriefing with the patient after the event to discuss the forced intervention and considering ways to reduce the likelihood of using force in future care of the patient.…”

Is it safe? The restraint chair compared to traditional methods of restraint: A three hospital study

“…Currently, there is limited literature regarding the restraint chair, which has been attributed to the fact that it originated as a law enforcement tool, not a medical device (Castillo, Coyne, Chan, Hall, & Vilke, 2015). In law enforcement and corrections, few risks have been directly related to the use of the restraint chair and available medical literature suggests that deaths associated with the use of the restraint chair have occurred for reasons other than the chair itself (Castillo et al, 2015). Proper use of the restraint chair requires constant observation of the patient while in the chair with nursing assessment occurring every fifteen minutes (Connor, 2007).…”

“…The ability to have patients in an upright position provides for ease of control for nursing staff during emergency situations while reducing the risk to patients by not resulting in changes to oxygen saturation of the restrained patient (Castillo et al, 2015). The position of the patient could also contribute to a shorter restraint episode.…”