Excessive Restraint

by Dish Staff

Medical resident Ravi Parikh considers the cons of physically restraining patients:

In some situations, restraints may be ineffective and even harmful. Doctors and nurses often employ restraints when a patient is at risk for falling or delirious. However, evidence suggests that restraints do not reduce one’s risk of falling.  Likewise, a study in the Journal of the American Medical Association suggested that restraints increase the risk of delirium in the hospital by 4-fold, possibly by increasing patients’ levels of anxiety and stress due to involuntary immobilization.  Physical restraints and the resulting immobilization they cause are also associated with increased rates of pressure ulcersrespiratory complications—and even death via strangulation and aspiration. Even more disturbingly, a 2006 report by the U.S. Department of Health and Human Services concluded that hospitals failed to report more than 40 percent of deaths related to restraints to The Centers for Medicare and Medicaid Services (CMS).

Though these statistics may make the ICU seem like an asylum, it is not. The majority of patients I cared for in the ICU never required restraints. And for the others who were confused or agitated, our team could usually avoid restraints by adjusting or prescribing medication.