Limb restraint
Encyclopedia
Limb restraints are physical restraint
s that are applied to a person's arm
s or leg
s. The application of limb restraints on both arms and legs at once is sometimes known as a four-point restraint.
As a medical restraint, limb restraints are soft, padded cuffs which are applied to a patient to prevent the patient from causing harm to him/herself or to others. The device consists of cuffs which are wrapped around the patient's wrist
s or ankle
s, and straps that are attached to the frame of their bed or chair.
Limb restraints are often used on a combative or disoriented patient who is using his/her arms or legs to strike at staff or others, to pull important medical apparatus, such as an IV tube
or catheter
, out of their body, or to otherwise interfere with their care. Arm restraints also become necessary when a patient must lie on his/her back at all times.
Patients who may come in need of limb restraints include those who have suffered a head injury
, those recovering from seizures (usually multiple ones), have been under anesthesia
for a long period of time, or those suffering from mental illness
, dementia
, or side effects
from their treatment.
Four-point restraints heavily restrict the movement of a patient, and may render the patient helpless when s/he needs to move in an emergency. Many facilities will hire a companion
to watch a patient who is placed under four-point restraint.
Most patients who find themselves restrained naturally think they can free themselves by pulling hard at the restraints. But the restraints are made out of plastic mesh, which cannot be broken by being pulled with human strength. Other patients attempt to unfasten the restraints around the wrist, but find they cannot reach the fastener unless they have abnormally flexible joints. Some do manage to slip their hands through the cuff, though competent workers prevent this from happening.
The easiest way to free oneself from restraints is to reach with one hand to the side of the bed, which is possible. There, the restraint is tied and can be easily untied. After freeing one arm, it is easy to use it to free the other. The patients who seem to know this the most are those who have previously worked in acute health care settings.
All restraints require a physician's order to be applied. While fabric restraints can be applied by a nurse temporarily while awaiting for a physician's order in an acute care setting, leather restraints can only be applied if pre-authorized by a physician.
Metal restraints are only permitted to be used on patients who are in legal custody or whose behavior in the health care setting is of a criminal nature (e. g. assaulting or making verbal threats of assault toward health care worker). Most jurisdictions have judges on call 24 hours who can issue court orders promptly when necessary.
activities, such as in Spreadeagle bondage .
Physical restraint
Physical restraint refers to the practice of rendering people harmless, helpless or keeping them in captivity by means such as handcuffs, fetters, straitjackets, ropes, straps, or other forms of physical restraint...
s that are applied to a person's arm
Arm
In human anatomy, the arm is the part of the upper limb between the shoulder and the elbow joints. In other animals, the term arm can also be used for analogous structures, such as one of the paired forelimbs of a four-legged animal or the arms of cephalopods...
s or leg
Human leg
The human leg is the entire lower extremity or limb of the human body, including the foot, thigh and even the hip or gluteal region; however, the precise definition in human anatomy refers only to the section of the lower limb extending from the knee to the ankle.Legs are used for standing,...
s. The application of limb restraints on both arms and legs at once is sometimes known as a four-point restraint.
As a medical restraint, limb restraints are soft, padded cuffs which are applied to a patient to prevent the patient from causing harm to him/herself or to others. The device consists of cuffs which are wrapped around the patient's wrist
Wrist
In human anatomy, the wrist is variously defined as 1) the carpus or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand;...
s or ankle
Ankle
The ankle joint is formed where the foot and the leg meet. The ankle, or talocrural joint, is a synovial hinge joint that connects the distal ends of the tibia and fibula in the lower limb with the proximal end of the talus bone in the foot...
s, and straps that are attached to the frame of their bed or chair.
Limb restraints are often used on a combative or disoriented patient who is using his/her arms or legs to strike at staff or others, to pull important medical apparatus, such as an IV tube
Intravenous therapy
Intravenous therapy or IV therapy is the infusion of liquid substances directly into a vein. The word intravenous simply means "within a vein". Therapies administered intravenously are often called specialty pharmaceuticals...
or catheter
Catheter
In medicine, a catheter is a tube that can be inserted into a body cavity, duct, or vessel. Catheters thereby allow drainage, administration of fluids or gases, or access by surgical instruments. The process of inserting a catheter is catheterization...
, out of their body, or to otherwise interfere with their care. Arm restraints also become necessary when a patient must lie on his/her back at all times.
Patients who may come in need of limb restraints include those who have suffered a head injury
Head injury
Head injury refers to trauma of the head. This may or may not include injury to the brain. However, the terms traumatic brain injury and head injury are often used interchangeably in medical literature....
, those recovering from seizures (usually multiple ones), have been under anesthesia
Anesthesia
Anesthesia, or anaesthesia , traditionally meant the condition of having sensation blocked or temporarily taken away...
for a long period of time, or those suffering from mental illness
Mental illness
A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture. Such a disorder may consist of a combination of affective, behavioural,...
, dementia
Dementia
Dementia is a serious loss of cognitive ability in a previously unimpaired person, beyond what might be expected from normal aging...
, or side effects
Adverse effect (medicine)
In medicine, an adverse effect is a harmful and undesired effect resulting from a medication or other intervention such as surgery.An adverse effect may be termed a "side effect", when judged to be secondary to a main or therapeutic effect. If it results from an unsuitable or incorrect dosage or...
from their treatment.
Four-point restraints heavily restrict the movement of a patient, and may render the patient helpless when s/he needs to move in an emergency. Many facilities will hire a companion
Companion (caregiving)
In health care and caregiving, a companion, sitter, or private duty may be a nursing assistant or similar professional who is hired to work with one patient...
to watch a patient who is placed under four-point restraint.
Most patients who find themselves restrained naturally think they can free themselves by pulling hard at the restraints. But the restraints are made out of plastic mesh, which cannot be broken by being pulled with human strength. Other patients attempt to unfasten the restraints around the wrist, but find they cannot reach the fastener unless they have abnormally flexible joints. Some do manage to slip their hands through the cuff, though competent workers prevent this from happening.
The easiest way to free oneself from restraints is to reach with one hand to the side of the bed, which is possible. There, the restraint is tied and can be easily untied. After freeing one arm, it is easy to use it to free the other. The patients who seem to know this the most are those who have previously worked in acute health care settings.
Types of limb restraints
Limb restraints can be fabric, leather or metal. The most commonly used type of limb restraints are fabric restraints. If fabric restraints are inadequate to restrain a patient, leather or metal restraints can be used. In most places, legal restrictions apply to the use of restraints in clinical settings.Leather restraints
Leather restraints are used for strong patients for whom soft restraints fail to prevent escape. They can be applied around the waist, or to individual limbs.All restraints require a physician's order to be applied. While fabric restraints can be applied by a nurse temporarily while awaiting for a physician's order in an acute care setting, leather restraints can only be applied if pre-authorized by a physician.
Metal restraints
Metal restraints are usually made of stainless steel. They are used for patients for whom fabric and leather restraints fail to prevent escape. But legally, they can only be used with a court order and with a member of law enforcement present within 500 feet without the use of an elevator or more than one flight of steps up or two down.Metal restraints are only permitted to be used on patients who are in legal custody or whose behavior in the health care setting is of a criminal nature (e. g. assaulting or making verbal threats of assault toward health care worker). Most jurisdictions have judges on call 24 hours who can issue court orders promptly when necessary.
Other uses
Limb restraints are a sexual fetish for some people, and are used in some BDSMBDSM
BDSM is an erotic preference and a form of sexual expression involving the consensual use of restraint, intense sensory stimulation, and fantasy power role-play. The compound acronym BDSM is derived from the terms bondage and discipline , dominance and submission , and sadism and masochism...
activities, such as in Spreadeagle bondage .