Chemical Restraints, Physical Restraints, and Other Demonstrations of Force

Wilson, Michael P.; Sloane, Christian

doi:10.1002/9781118292150.ch13

Cited by 6 publications

(2 citation statements)

References 28 publications

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“…Involuntary mental health holds are a legal type of restraint in which patients are not allowed to leave the ED [15][16][17]. These patients are not infrequent in the ED setting [18].…”

Section: Introductionmentioning

confidence: 99%

Lengths of stay for involuntarily held psychiatric patients in the ED are affected by both patient characteristics and medication use

Wilson¹,

Brennan²,

Modesti³

et al. 2015

The American Journal of Emergency Medicine

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Background: Psychiatric patients experience longer treatment times (length of stay [LOS]) in the emergency department (ED) compared to nonpsychiatric patients. Although patients on involuntary mental health holds are relatively understudied, common wisdom would hold that times for these patients can only be affected by addressing systems issues because they are not free to leave. The objective of this study was to determine whether both selected ED and patient-specific factors were associated with longer LOS. We hypothesized that nonmodifiable factors (age, sex, agitation, presentation during evenings/nights, presentation during weekends, suicidal ideation) would prolong LOS but that potentially modifiable factors (such as use of medication) would reduce LOS. Methods: A historical cohort of patients (January 1, 2009-August 16, 2010) placed on involuntary mental health holds was studied in 2 general EDs. A regression model was used to calculate the effects of modifiable and nonmodifiable factors on LOS. Results: Six hundred forty patient visits met all inclusion/exclusion criteria. Longer LOSs were significantly associated with suicidal ideation, use of antipsychotics, and use of benzodiazepines, although agitation did not predict longer LOSs. Longer LOSs were also longer with presentation on the weekends. Conclusions: Lengths of stay for patients on involuntary mental health holds are associated with several factors outside the control of the typical ED clinician such as the ability to clear holds quickly due to day of week or placement of the hold for suicidal ideation. Lengths of stay are also increased by factors within the control of the typical ED clinician, such as administration of calming medication.

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“…Involuntary mental health holds are a legal type of restraint in which patients are not allowed to leave the ED [15][16][17]. These patients are not infrequent in the ED setting [18].…”

Section: Introductionmentioning

confidence: 99%

Lengths of stay for involuntarily held psychiatric patients in the ED are affected by both patient characteristics and medication use

Wilson¹,

Brennan²,

Modesti³

et al. 2015

The American Journal of Emergency Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…For instance, experimental evidence and expert consensus now favors the use of antipsychotics other than haloperidol, which are just as effective yet far more benign. Professional societies and regulatory agencies now discourage the use of behavioral restraints, calling for their use only as a last resort (9)(10)(11)(12)(13)(14). Weapons typically used by law enforcement, such as tasers or mace, are not allowed for use by health care providers (15).…”

mentioning

confidence: 99%