This page is STILL under CONSTRUCTION!
Until this "blurb" is REMOVED, this page remains a "rough draft" version, and its contents should NOT NECESSARILY be implemented as currently written. However! Protocol-writers with a strong understanding of the information contained within the articles, "All Tied Up & No Place To Go" and "Restraint Asphyxia – Silent Killer," should be able to use this "ROUGH" information to build their own protocol. If you have "time" to delay your protocol writing, PLZ check back here periodically, to see if MY version of this protocol has been completed!

The following text was "PLUGGED IN HERE" from, "All Tied Up & No Place To Go"

DOCUMENTATION OF RESTRAINTS:

Improper or inadequate documentation of restraint will damn you in a court of law. If what you "recall" about patient-care delivery and management (actions that occurred many months – even years – before) does not fully correspond with what you documented, your credibility is discounted.(9)

When you have restrained a patient, you "SHOULD" document all of the following:

1. That an EMERGENCY existed and the
   NEED FOR TREATMENT was EXPLAINED to the patient.
2. That the PATIENT REFUSED TREATMENT or was
   UNABLE TO CONSENT TO TREATMENT (such as an unconscious patient).
3. EVIDENCE of the patient's INCOMPETENCE (or inability to refuse treatment).
4. FAILURE of LESS RESTRICTIVE METHODS of RESTRAINT (if conscious, failure of VERBAL ATTEMPTS to convince the incompetent patient to consent to treatment).
5. ASSISTANCE of LAW ENFORCEMENT OFFICIALS with restraint,
   and/or ORDERS from MEDICAL CONTROL to restrain the patient,
   and/or ADHERENCE to SERVICE RESTRAINT PROTOCOLS.
6. That the TREATMENT and RESTRAINT was for the PATIENT'S BENEFIT and SAFETY.
7. That the REASONS for RESTRAINT were EXPLAINED TO THE PATIENT.
8. The TYPEs of RESTRAINT EMPLOYED (soft, leather, mechanical).
9. The LIMBS RESTRAINED (right wrist, bilateral wrists, "four points").
10. Any INJURIES THAT OCCURRED DURING or AFTER RESTRAINT.
11. CIRCULATION CHECKS every 15 (or fewer) MINUTES.(2, 8, 11)
12. The BEHAVIOR and/or MENTAL STATUS of PATIENT AFTER RESTRAINT.

Certainly, not every restraint situation requires such extensive documentation. I routinely document only those points numbered 2, 3, 5, 8, 9, 10, 11, and 12. However, we are all familiar with the litigious nature of today's society. Whenever you have restrained someone who strikes you as having a litigious nature, or when the bystanders or family members strike you as having a litigious nature, the more of these points that you document, the more protected you will be by your documentation.

For a "QUICK LOOK" reference card similar to this one, so you have a handy on-scene or post-scene restraint reference, GO TO THE QUICK LOOK CARD PAGE!

AH. NOW, I see that I'd also been working on this (The Stuff Below), BEFORE! I don't have time right now to see if the stuff below DIFFERS from the stuff above.

What part of "A Work In Progress" aren't you picking up on?! LOL!

RESTRAINT DOCUMENTATION GUIDELINES:

1. That an EMERGENCY existed and the NEED FOR Tx was EXPLAINED to the Pt.
2. That the PT. REFUSED or was UNABLE to CONSENT to Tx (unconscious?).
3. EVIDENCE of the patient's INCOMPETENCE (or inability) to refuse treatment.
4. LESS RESTRICTIVE METHODS of RESTRAINT attempted.
5. ASSISTANCE of LAW ENFORCEMENT OFFICIALS with restraint,
   and/or ORDERS from MEDICAL CONTROL to restrain,
   and/or ADHERENCE to SERVICE RESTRAINT PROTOCOLS.
6. That the Tx and RESTRAINT was for the PT's BENEFIT and SAFETY.
7. That REASONS for RESTRAINT were EXPLAINED to the PT.
8. The TYPEs of RESTRAINT EMPLOYED.
9. The LIMBs RESTRAINED (right wrist, bilateral wrists, "four points").
10. Any INJURIES THAT OCCURRED DURING or AFTER RESTRAINT.
11. CIRCULATION CHECKS every 15 (or fewer) MINUTES.
12. BEHAVIOR and/or MENTAL STATUS of PT AFTER RESTRAINT.

Document at LEAST 2, 3, 5, 8, 9, 10, 11, and 12
for EVERY Use of Restraint!

APPROPRIATE, SAFE & EFFECTIVE, RESTRAINT PROTOCOLS:

• 1) Introduction to Patient Restraint Universal Reasons For,
  and Basic Principles Regarding, SAFE Patient Restraint

• 2) Restraint Protocol for EVERY Unconscious Patient

• 3) Resistively Confused Patient Restraint Protocol

• 4) Violently Confused or Combative Patient Restraint Protocol

• 5) Response When Forceful-Prone-Restraint (or Hobble Restraint)
  is Employed Prior To Your Arrival

• 6) Spinal Immobilization Protocol for the
  Violently Confused or Combative Trauma Patient

• "Quick Look" On-Scene Restraint Reference Card

Email Charly at: c-d-miller@neb.rr.com
Those are hyphens/dashes between the "c" and "d" and "miller"