Protective Restraint In The ICU: Patient Safety And Rehabilitation

As a patient or family member of a patient, you may have wondered why a patient in ICU, whose condition is obviously very serious, has to be tied up. In fact, this "tie the patient" behavior is not unreasonable, it is a commonly used nursing measures, known as "protective restraint".

The main purpose of protective restraints is to prevent patients from removing tubes related to treatment, to prevent falling out of bed, and to prevent self-injury and other accidental injuries. It is used primarily for patients who are at risk for extubation or the possibility of self-injury, such as:

1、Patients in agitated phase and delirium.

2、Those who are unconscious and cannot fully cooperate with the treatment.

3、Patients in post-traumatic pain period.

4、in the anesthesia awake period or sedation daily need to wake up the patient.

5、Patients with cerebrovascular accident or sequelae and obvious mental symptoms.

6、Patients with various kinds of tubes left in the body.

01 How to use protective restraint?

In the use of protective restraints, there must be a doctor or nurse assessment, the results of the assessment need to be issued by the nurse in accordance with the standard provisions of the medical advice to implement.

During the restraint process, it is important to maintain a functional position and some degree of mobility of the restrained limb with the restraining belt, the tightness of the restraining belt or restraining gloves to accommodate 1-2 transverse fingers, and skin protection at the site of restraint. At the same time, we should pay attention to communicate with awake patients at any time to understand their feelings and needs; observe the blood circulation of the restraining site and the tightness of the restraining belt once every 15 to 30 minutes and adjust it in time; take turns to loosen the restraining site for 30 seconds in every 2 hours; observe the patient's coldness and warmth, urination and defecation, the circulation of the restrained site on a regular basis, and replenish the water regularly to do a good job of the basic nursing care and the prevention of pressure ulcers. We should do the basic nursing care and prevent pressure ulcers.

02 When can the restraint be released?

Physical restraint is one of the main measures in many countries to prevent medical interference (mainly unplanned extubation of patients) in ICUs; physical restraint is an important measure to reduce unplanned extubation. When to release the restraints needs to be assessed by the healthcare provider, and the release of protective restraints can be considered when the patient is stable, conscious, and can cooperate with treatment and self-control his/her behavior, and at the same time, there is no risk of extubation or falling out of bed.

Protective restraints are designed to protect the patient and support the continuity of treatment, with the goal of protecting the patient's safety as the first priority. When the family questions and does not understand, the healthcare provider should answer them in detail. The ultimate goal is patient safety, early recovery, and avoidance of damage to the body.

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