Restraints - Face Up Or Face Down?

[PRNMEDS]

I work in a small Psych hospital, and the majority of pateints are Adolescents. Hospitals policy for 4 point restraints has been to restrain the patient face down (we use leather restraints on each limb).

Recently the State agency in charge has strongly recommended face up (due to a recent death in another hospital), so we have been trying face up when able, but continuing to use face down as well.

My question is what are other peoples experiences with this, and which do you prefer? Which is safer?

Having been trained initialy in Face Down - I tend to prefer this and find I get spit on less, and have easier access to give injection. Also feel Pt. is less likely to choke.

Thanks.

[Wolfpax]

I have heard of face up, also in an adolescent psych unit a friend of mine worked in Fla. about 15 years back... we restrain face up on my psych unit...

I had pretty good control of patients when I was on the MICU, we'd strap them to the stretcher flat prior to transport, and then sit the seat up which gave a bit of extra restraint and ensured minimal movement...then again it was only for transport purposes...

[TitaniaSidhe]

Face up only in our facillity, never have seen face down...initially for the IM but then immediately flip over. Sometimes not even for the IM if they are too out of control.

[Frankcah]

Even thought there is a small risk of suffocation with patients in a face down restraint, it is inevitable that it happens occasionally in what is the usual melee to restrain a patient when it is needed.

Check out the report of "The Bennett Inquiry" into the death of a man in the UK as a consequence of face down restraint. One of the recommendations of this was that face down restraint should only be carried out for a max of 3 minutes.

Face up restraint is as safe as the competence of those carrying out the restraint. I too detest spit, but then again it sure beats being headbutted, punched, kicked, hair pulled, strangled, hung, drawn & quartered... :roll

[RedWhiteBlue]

i've been a nurse for 25 years with psych, icu, and er experience, and i have never ever heard of putting restraints on a face down patient. i have heard of briefly doing a facedown physical hold, but that is no longer acceptable in our facility - we only do standing physical holds now. don't forget that im injections can be given in the thigh. i'm not sure if i believe that positional asphyxia can occur if repositioning is done when respirations cease, but recently a paramedic in my area was charged with murder with the premise being positional asphyxia (the person at one point was restrained face down). the paramedic was aquitted, but would you (any of you) want to be charged with murder?

for more information on this case (search boggess):

archive.dailyindependent.com/

i'm not sure i got the link so that it will actually work, but you can copy and paste....