Restraints

Started by europeman
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E

europeman

Trauma Surgeon / Intensivist
15+ Year Member
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?
 
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".
 
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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