Restraints

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europeman

Trauma Surgeon / Intensivist
15+ Year Member
Joined
Nov 12, 2007
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Ball park what percentage of your intubated patients have wrist restraints? I fear where I'm doing fellowship I may have a screwed idea/training about this. We seem to use it on.... Well everyone!


Thoughts?

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On patients who are directable, and awake not delirious most have restraints removed and we attempt to ambulate if feasible which seems to help with the "grabby's". In sedated or confused/altered patients the reality is most patients have restraints, I know I know I'm contributing to their confusion and delirium, but nursing a). feels it's unsafe especially if not 1:1 b). they would make my day miserable and I feel more patients would have lower RAAS scores as nurses would up titrate sedation to maintain "safety".
 
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Less than 50% if mechanically ventilated and not working toward extubation; any effort toward the tube (or witnessed elbow flexion) results in "reminder straps"
 
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