RESTRAINTS – Purposes and Types of Restraints (CHILD HEALTH NURSING)
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Restraints are used to restrict the movements of the sick baby in the bed. The restraints should select the appropriate, safe and comfortable one. However, the use of restraints should be restricted to the minimum
PURPOSES
- Children may need to be restrained for some diagnostic therapeutic procedure or during physical examination and also in order to protect the child from injury
- Restraints maintain the child’s safety and protect him from injury. It also facilitates examination and minimizes the child’s discomfort
TYPES OF RESTRAINTS
- Mummy device: mummy device involves securing a sheet or blanket around the child’s body in such as way that his arms are held to his sides and his leg space movements are restricted
Purposes of mummy restraint are examination or treatment of the head and neck, e.g. ENT examination or scalp venipuncture
Procedure: the child is placed in an open blanket which is adjusted in such a way that one edge is under the child’s neck and another extends beyond its feet. The child’s arms are placed by the sides
- Elbow restraints: elbow restraints is used to prevent the infant from flexing his elbow so that he is unable to remove the nasogastric tube or scalp vein
Purpose: elbow restraints are – this may be useful in cases after operation on head, face, scalp infusion, to secure transanostomotic nasogastric tubes and to prevent scratching in case of skin disorder
Procedure: elbow is extended, padded and bandaged with a wooden spatula placed on the anterior or flexor aspect
- Jacket restraint: jacket restraint is used to prevent the child from climbing out of the crib or chair
Procedure: the jacket is put on the child keeping the laces at the back, so that child cannot touch them. The long tapes on the jacket are fixed to the under structure of the crib
Clove-hitch restraint: clove-hitch restraint is used to immobilize the arm or leg. It is prepared from a piece of gauze or soft cloth or crepe bandage
Procedure: the wrist or ankle is placed in the loops of the device. The ends of the device are pulled to make it firm and tied to the cot frame. It should be tight enough to prevent slipping off the hand or foot
- The crib-net restraint: crib-net restraint is used to prevent the child from climbing over the side rails. It is applied over the crib and on the sides of the crib
Procedure: the crib net restraint should be fixed to the cot frame, so that the side rails can be lowered when necessary without removing the net. When the rails are up, the child can stand in the crib but cannot climb over the side rails
- Restraint with hand: restraint with hands provides bodily contact and a feeling of security. It is useful for infants and restraining for certain procedures
Purposes: of restraint with hands – positioning for femoral venipuncture and restraining for lumbar puncture
Procedure: femoral venipuncture – the infant placed on his back and his legs spread apart in a frog like fashion. Lumbar puncture – infant placed on lateral side, the knees and neck are in a flexed position
