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Patient containment measures

Set of actions taken in order to immobilize a patient in bed when all other measures taken have been ineffective.


Prevent the patient from injuring himself or others.


– Scissors. – Articulated bed.


– Mechanical restraints. – Nursing records.


Determine the type of restraint to be used according to the needs of each patient. If it is going to be complete or partial. Before choosing the measure, the following aspects should be assessed:

1. Limiting the patient’s movement as little as possible. If it is only necessary to restrain one arm, it is not necessary to restrain the whole body. 2. Do not interfere with the patient’s treatment or health problem. 3. Ease of change, restraints should be changed often and always be clean. 4. Be safe for the patient. 5. As inconspicuous as possible. – Perform hand washing. – Move the material to the patient’s room. – Preserve the patient’s privacy. – Inform the patient and family of the need for restraint and the necessary behaviors for the cessation of the intervention. – Assign sufficient personnel to assist in the safe application of restraint devices. Personnel involved in restraint should not carry objects that can cause injury or breakage. – Place the patient in the correct anatomical position. – Remove rings, bracelets, necklaces and protect bony prominences.


1. Place restraints well padded and with moderate pressure. 2. Secure the restraints out of the patient’s reach, to the immobile bed frame (not to the bed rails). 3. Check the condition of the skin at the point of restraint: color, temperature and sensitivity of the restrained extremities. 4. Allow movement and exercise according to the patient’s level of self-control, condition and ability.


1. Hold the patient at waist or chest level below the axillae. 2. Place the restraint over the patient’s pajamas (never over the skin). 3. Check the condition of the skin at the point of restraint: color, temperature. 4. Assess the patient’s breathing.


1. It is based on special folds of a blanket or sheet around the infant to prevent movement during the performance of a procedure such as gastric lavage, or the drawing of a blood sample. 2. Choose a sheet or blanket with the distance between the two corners twice that of the child’s body and spread it out on a flat surface. 3. Fold one corner and place the child in the supine position. 4. Fold the right side of the sheet over the child’s body, leaving the left arm free. 5. Fold the lower part of the blanket over the child. 6. Place the left arm in its natural position and cover with the left side of the sheet, tucking the sheet under the body. 7. Remain at the child’s side with a mummy-type restraint until the procedure is completed. – Perform patient restraint in a quick, coordinated and efficient manner (no more than 10 minutes). – Check the patient’s immediate environment and remove any objects that may be dangerous. – Assess at least every 8 hours the patient’s need for continued restraint. – Gradually remove restraints as self-control increases. – Assess the patient’s response to restraint removal. – Remove equipment. – Perform hand washing. – Record in nursing documentation: rationale for intervention, type of restraints used, patient’s response to restraint, signs and symptoms of possible complications, and reasons for cessation if applicable.


– Frequent review of restraints. – This procedure should be carried out when all other protective measures have failed. – Potential complications to watch for include: – Pressure ulcers. – Peripheral ischemia. – Nerve compression. – Dislocations, fractures. – Thromboembolism. – Bronchoaspiration. – Respiratory insufficiency.

– Indications: states of psychomotor agitation, confusional states, states of self/heteroaggressiveness. – From the ethical point of view, mechanical restraint is a useful and even necessary procedure as long as it complies with clinical indications.

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