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Tips to Prevent Self Injury

Disabilities   (241 Views 3 Comments)
by dholly2015 dholly2015 (New) New

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Hey guys! I was wondering do any of you have any suggestions or tips on how to prevent developmentally delayed pediatric patients from injurying themselves? Specifically removing PD catheters, MB, trachs? Pts like the ones I have dealt with often do not react when they do remove these invasive devices and tissue damage/infection is a great concern. This issue is especially challenging at night during sleeping hours bc pt does not sleep well then. 

I have tried to apply my nursing knowledge and “Mama knowledge” but have hit a wall at this point. I have also conducted my own research and viewed scholarly articles on this subject. I am not finding much out there unless it applies to the autistic child with suggestions like removing pt from stimuli, keeping a consistent schedule, or determining why the behavior is occurring. Everything I have read suggests that until the “why” is determined, the same behavior will continue either due to positive or negative reinforcements. 

Also, how is swaddling viewed these days as a deterrent? Is it considered a restraint sometimes or always? Does it depend on the chronological or developmental age? Are there any other options that I may not be thinking of? 

 

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Kitiger has 40 years experience as a RN and specializes in Private Duty Pediatrics.

1 Follower; 938 Posts; 18,824 Profile Views

10 hours ago, dholly2015 said:

Hey guys! I was wondering do any of you have any suggestions or tips on how to prevent developmentally delayed pediatric patients from injurying themselves? Specifically removing PD catheters, MB, trachs? Pts like the ones I have dealt with often do not react when they do remove these invasive devices and tissue damage/infection is a great concern. This issue is especially challenging at night during sleeping hours bc pt does not sleep well then. 

 

What is "MB"?

A onsie works well to keep hands away from tubes, etc., on the abdomen. They come in all sizes https://www.amazon.com/dp/B019VHO83M?tag=sa-sym-new-20&linkCode=osi&th=1&psc=1

An oversized sleeper put on backwards is hard for the child to remove. It's even harder to for him to remove if you wrap a piece of duct tape over his sleeper, around his waist.

If he grabs things through the cloth of the onsie, you can sew an extra layer of a stiffer material - maybe corduroy - over the area that needs protection.

You might consider mittens.

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13 Posts; 532 Profile Views

47 minutes ago, Kitiger said:

What is "MB"?

A onsie works well to keep hands away from tubes, etc., on the abdomen. They come in all sizes https://www.amazon.com/dp/B019VHO83M?tag=sa-sym-new-20&linkCode=osi&th=1&psc=1

An oversized sleeper put on backwards is hard for the child to remove. It's even harder to for him to remove if you wrap a piece of duct tape over his sleeper, around his waist.

If he grabs things through the cloth of the onsie, you can sew an extra layer of a stiffer material - maybe corduroy - over the area that needs protection.

You might consider mittens.

Oops, MB = Mickey Button. Family insists on wearing open gowns/dresses. In other words, I am limited on clothing options. We have tried mittens and she has figured out how to remove them with her teeth!! After realizing that we started putting her socks over her hands and reinforcing with tape. I’m still trying to visualize the corduroy you mentioned. 🤔

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