[swiss brian]

hello everyone.
on my picu in st. gallen, switzerland, we are attempting to develop a standard guideline for the use of physical restraint in ped. icu. we have based it on the american society for critical care medicine guidelines from 2003, and are trying out the richmond sedation agitation scale as an asessment instrument. do any of your units have a guideline in use. i havent found any pediatric specific literature. it would be great if anyone had some tips to give us
thanks

[Qwiigley]

When I began PICU care apprx 15 yrs ago, all the kids on a vent were paralyzed with norcuron (vecuronium). Then we evolved to 2 pt soft restraints, then no restraints if a family member signed a form to watch over them. Nowadays, no restraints unless the kid has proven that he will pull his tube. That's when I left and went back to school!!!
We don't use a tool at all. No other criteria. Sad, but true. (25 bed PICU) Separate Cardio-thoracic ICU (20 beds) and separate NICU another 35 beds.

[irisRN]

We do 2 pt soft wrist restraints whenever the kids have anything they can remove...ET tubes, RAs, chest tubes, etc. They require lots of documentation and a 2 RN check. We usually do not use vec drips for this purpose (though it depends on the patient).