Adverse Effects
Associated With
Physical Restraint

This article is available from the Canadian Psychiatric Association's Canadian Journal of Psychiatry as a "pdf" (Adobe Acrobat) file format, and I don't have time to html-code it. So, I'm posting it's "pdf" file!

If you don't have an Adobe Acrobat program on your computer, you can download a FREE version HERE. The free program will allow you to open, read and print any pdf file, or copy any entire pdf file to your computer. However, you have to have a PURCHASED version of Adobe Acrobat 6.0 to "SELECT" and copy specific text from any pdf file.

My Review of this Article is so brief, I'm posting it here!

The authors offer several entirely inadequate "Recommendations" in this article. I'm not going to go into all of them. So, here's ONE example:

"Psychiatric units should be equipped to deal with potential cardiovascular emergencies, and clinicians should be competent to recognize potential cardiac problems and have current certification in cardiopulmonary resuscitation."
Well, gosh. CPR and ACLS certification and performance of even expertly aggressive "advanced" resuscitation measures will NOT resuscitate someone dead due to restraint asphyxia. [See all the Metabolic Acidosis study reports.] So, that recommendation is after-the-fact, and entirely inadequate.

And, I'm terrifically disappointed by this article's "CONCLUSION.":

"The extant literature on restraints does not represent a body of knowledge upon which clinicians can base continued uncritical use of this quasi-therapeutic and security measure. Research is needed to provide clinicians with data on both the risk factors and adverse effects associated with restraint use, as well as data on procedures that will reduce these coercive measures. Research is also needed to determine what individual and combined risk factors contribute to injury and death."
These authors documented PLENTY of information and observances clearly indicating that forceful-prone-restraint can KILL. How many more deaths have to occur before these authors GET OFF THE FENCE and take a stand about what they know to be true?

Thankfully, these authors DID at least manage to strongly state the following important observations. (My bold faced italics!): "Staff applying restraints must understand that struggling against restraint may not simply be oppositional. Because it may represent a natural response to the subjective feeling of being unable to breathe, correct assessment of these situations is critical. The third author has encountered several clinical situations in which staff members attributed a patient's struggles to belligerence, when they were in fact agitation caused by hypoxia. Typically, as patients' struggles intensify, staff increase the pressure of their hold until patients stop resisting. When a patient ceases struggling, staff or police assume that patients have calmed down or that they are "playing possum." Reports indicate that restrained individuals at that point have either been left alone or staff members have intensified holds for extended periods when struggling persisted. Too often, however, calm behaviour has indicated that restrained patients are in respiratory arrest or have died." Those observations are entirely accurate. But, again, how many more forceful-prone-restraint deaths have to occur before these authors GET OFF THE FENCE and take a stand about what they know to be true?

That's it for my "review!" Here comes your link to the article.

Mohr WK, Petti TA, Mohr BD: Adverse effects associated with physical restraint.
Can J Psychiatry June, 2003;48:330-337.

Here is a link to the pdf copy I've "stored" in my RA Library:
Adverse Effects Associated With Physical Restraint

If that link doesn't work, you'll have to go "outside" my RA Library to obtain this article. (There won't be a link back to the RA Library from there.):

The Canadian Journal of Psychiatry's Adverse Effects Associated With Physical Restraint pdf file.

The Canadian Journal of Psychiatry's Archived June 2003 Issue containing their link to the "Adverse Effects Associated With Physical Restraint" pdf file

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OR Use the Following Links:

Return to the Restraint Asphyxia LIBRARY

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COUNTER started in January, 2004