The use of physical restraints on paediatric intensive care units

Abstract

Physical restraint is a commonly used technique on PICU in the UK. There is considerable variation in clinical practice and current clinical guidelines which are available do not deal specifically with children. Prospective randomized trials would be necessary to fully investigate the role of physical restraints amongst critically ill children.

Holding and restraining children for clinical procedures within an acute care setting: an ethical consideration of the evidence

“…; Graham and Hardy ; Homer and Bass ). Some studies also described devices which had been used to hold children or young people; these included splinting (Ofoegbu and Playfor ; Crellin et al. ; swaddling (Graham and Hardy ; Ofoegbu and Playfor ; Demir ), straps (Ofoegbu and Playfor ; Demir ) and commercial devices in radiological settings (Graham and Hardy ; Dashti et al.…”

Unplanned extubation in pediatric critically ill patients: A systematic review and best practice recommendations*

“…Physical restraints have been widely used in PICU to facilitate the tolerance of invasive monitoring and therapy and in an attempt to avoid treatment interference when the abrupt discontinuation of a treatment or intervention may lead to development of life-threatening complications (38). However, the role of physical restraints in preventing UE has not been prospectively studied (38).…”

“…However, the role of physical restraints in preventing UE has not been prospectively studied (38). Therefore, the main consensus in the adult literature is that the use of physical restraints has no scientific basis and that the benefits are unproven (39).…”

The use of physical restraints on children: practices and attitudes of paediatric nurses in Turkey

“…It may be concluded from the findings in this research that the rate of PR in Turkey was higher than those previously reported elsewhere. Ofoegbu & Playfor (2005) determined that 19 units used PR for patients; among these, 10 units used manual holding, 16 units used splints across limb joints, and three units used swaddling as a restraint technique in PICUs. Some PR applications were reported as follows: mechanical restraint rate 4–49% (Donovan et al.…”

“…It has been seen from the literature that the rate of informed consent from children was low. Ofoegbu & Playfor (2005) found that no written consent was obtained but verbal consent was obtained at the rate of 53% before PR in PICUs. Sifers et al.…”