Use of Pulse Oximetry During Restraint Episodes

Masters, Kim J.; Wandless, Deborah

doi:10.1176/appi.ps.56.10.1313

Cited by 14 publications

(8 citation statements)

References 4 publications

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“…A further consideration is monitoring once restraint has been implemented. Masters and Wandless () and Masters () and Masters (38) have advocated the use of portable pulse oximeters to monitor oxygenation during restraint, and it is possible that using such equipment in the present case could have been clinically useful. Our hospital has local guidelines for handling aggression and violence.…”

Section: Discussionmentioning

confidence: 99%

Physical Restraint and Near Death of a Psychiatric Patient

Nissen

Rørvik

Haugslett

et al. 2012

Journal of Forensic Sciences

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Physical restraint is used as a last resort emergency measure to calm and safeguard agitated and/or aggressive psychiatric patients. This can sometimes cause injuries, and rare fatalities have occurred. One mechanism of injury and death while in physical restraint is that of severe asphyxiation. We present the case of a hospitalized man in his mid-30s, suffering from schizophrenia. The patient was obese. He became aggressive and had to be manually restrained with a "takedown." After having been put in the prone position on the floor with a significant weight load on his body, he lost respiration and consciousness. Subsequently, he was given CPR. He regained consciousness and respiration, while the cyanosis receded in 1-2 min. Psychiatrists and pathologists should be aware that physically restraining a patient in the prone position with a significant weight load on the torso can, in rare cases, lead to asphyxiation.

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Section: Discussionmentioning

confidence: 99%

Physical Restraint and Near Death of a Psychiatric Patient

Nissen

Rørvik

Haugslett

et al. 2012

Journal of Forensic Sciences

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“…Another is to ensure the availability of a portable automatic electronic defibrillator (AED). Relatively easy-to-use methods are available for monitoring signs of physiological danger during restraints (Masters & Wandless, 2005), including use of a pulse oximeter to monitor blood oxygen levels, frequently checking the student’s vital functions, and involving more than one adult to conduct the restraint, with at least one adult specifically responsible for monitoring the student’s well-being (CCBD, 2009a, 2009b). Couvillon and colleagues (2010) reviewed crisis intervention training programs and found that the all restraint-training programs reviewed provided varying degrees of training in monitoring students’ physical states and symptoms of physical distress during restraint, but none reported training in use of pulse oximetry or AED.…”

Section: Ethical Issues Related To Restraint and Seclusionmentioning

confidence: 99%

Professional Practice and Ethical Issues Related to Physical Restraint and Seclusion in Schools

Scheuermann

Peterson

Ryan

et al. 2016

Journal of Disability Policy Studies

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Use of physical restraint and seclusion procedures in schools continues to be controversial, and foster proposals for federal and state legislation and regulation. Despite much discussion about what policies are needed, there has been little discussion about the professional practice issues and the ethical issues related to these practices. The purpose of this report is to present six clusters of professional practice and ethical issues that have not heretofore been specifically identified. To do so, we will examine the codes of professional practice and ethics of organizations representing educators who work with students with severe behavioral challenges. To illustrate these issues, we use real-world case examples from media stories and official reports about problems resulting from restraint and seclusion. Although individuals may disagree regarding decisions about these ethical issues, these questions should be a part of any policy discussion related to professional practice regarding these issues, and they have rarely been addressed in the restraint and seclusion policy debate. In addition, they are also questions that must be examined by all professional educators for them to assure adherence to the professional practice and ethical codes for their field.

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“…Safety is an important outcome of coercive interventions such as seclusion or restraint. Reports on the frequency of adverse events are rare, mostly case reports or unpublished [18][19][20][21][22]45]. Though even fatal outcomes have repeatedly been described, such events are obviously too rare to be adequately investigated in a randomized clinical trial.…”

Section: Outcome Variablesmentioning

confidence: 99%

“…Some authors state that seclusion is the safest and most dignified intervention [16,17] while other reports estimated 50-150 deaths per year in the US due to poor monitoring or faulty technique [1]. Masters estimated 115 restraint related fatalities over a period from 1995 to 2004 [18]. Even when conducted correctly, fatal complications caused by restraint are described [19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of randomized controlled trials on seclusion and mechanical restraint

2008

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Corresponding to the procedures in emergency medicine informed consent can be obtained after the intervention when the patients are capable again. Informed consent refers only to participation in an interview and utilization of data. Randomization can be ethically approved, if exclusion criteria for randomization are defined. A comprehensive cohort study seems to be the most practicable study design. As primary outcome variable an assessment of subjective experiences of the patients' restrictions to human rights.

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Use of Pulse Oximetry During Restraint Episodes

Cited by 14 publications

References 4 publications

Physical Restraint and Near Death of a Psychiatric Patient

Physical Restraint and Near Death of a Psychiatric Patient

Professional Practice and Ethical Issues Related to Physical Restraint and Seclusion in Schools

Feasibility of randomized controlled trials on seclusion and mechanical restraint

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