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Use of Restraints

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Restraints are devices used to limit a child’s body movement. The Children’s Hospital of The King’s Daughters Health System is committed to preventing the use of restraint at every opportunity and will always attempt to use the least restrictive forms of restraint when possible. There are different reasons why a child might need to wear a restraint. Some of these reasons are listed below:

  • To prevent a child from pulling out lines and tubes.
  • To prevent a child from disturbing his wounds or bandages.
  • To keep a child in the correct position in bed when positioning is important for their healing.
  • To keep a patient from harming themselves or others.

Alternatives to restraints:

Restraints are never used as the first choice to manage these types of situations. There are other measures that can be trialed by the family or staff to try to prevent restraint use. These are some of the things you can do to help your child:

  • Use what works best to calm your child.
  • Speak to your child about medical procedures or equipment in a manner they can understand.
  • Stay with your child to provide comfort and to reduce anxiety, if at all possible. If you are not able to stay around the clock, ask a close adult family member or friend to visit when you cannot stay with your child.
  • Provide your child’s favorite play activities to distract attention away from their medical devices or condition. Our child life department has toys, games, video games, videotapes, and music that you can borrow.
  • Please tell us if your child is in pain. We want to do everything we can to control your child’s pain.
  • Reduce the amount of noise, light, and/or visitors in your child’s room to help decrease excitement.

Your nurse can contact a child life specialist if your child is having difficulty coping with hospitalization. If your child is anxious or has mental health concerns, we have mental health team members who can help with coping.

If restraints are still needed after these measures, the least restrictive device will be used for each situation. The usual types of restraints are listed below:

  • Mittens (if fastened at the wrist or fastened to the bedframe)—used to keep the child from scratching themselves or removing tubes or bandages.
  • Elbow Restraint—used to keep the child from rubbing his eyes after an operation or removing tubes or bandages that are above the waist.
  • Soft Cloth Wrist or Ankle Restraints—used to prevent a child from removing tubes or bandages.
  • Neoprene Velcro Extremity Restraints—used to limit the movement of the patient’s arms or legs when the soft cloth restraints are not effective.
  • Enclosed Bed—this special bed has padded rails and a soft net around the sides to prevent injury from hitting against the rails or falling out of bed when a child cannot control his movements.

THE NURSE WILL WATCH YOUR CHILD CLOSELY WHILE IN RESTRAINTS. THE NURSE WILL MAKE SURE THAT:

  • The right type and size of restraint is used. The nurse will use the least restrictive type of restraint possible.
  • The restraint is applied correctly. The restraint will be attached in a way that it can be removed in case of an emergency.
  • The restraint is not too tight or too loose. The nurse will check the warmth and color of all restrained body parts.
  • The skin under the restraint is okay. Each restraint will be removed at least every 4 hours for skin care and exercise of the restrained body part.
  • Your child’s need for food, liquids, bathroom visits, and walking are being met, as appropriate.
  • The least restrictive restraint possible is used. Restraints are changed to a less restrictive device as soon as possible.
  • The restraints are removed if the reason the restraint was needed is no longer present (for example, medical device or sites that needed to be protected are no longer present or your child is alert and their behavior no longer is a safety issue). 

While you are with your child, you can:

  • Reinforce what behaviors your child needs to show to allow the restraints to be removed.
  • Reassure your child that the restraint is not a punishment.
  • Do the activities that are listed as alternatives for restraint measures above.
  • Give skin care and exercise to the restrained areas after the nurse removes the restraint and checks your child’s skin. The nurse will show you how to rub the area to improve blood flow. The nurse may give you some lotion to put on the skin. The area can be moved around for a few minutes to keep the muscles working (range-of-motion). The nurse will show you how to do these exercises. The nurse will reapply the restraint.

Call the nurse if your child:

  • seems more confused or upset
  • needs to eat or drink, get up, or use the bathroom
  • needs pain control measures
  • is having trouble breathing
  • your child’s skin is cold and clammy
  • your child’s skin or nail beds are a blue or white color around or below the restraint
  • is more cooperative and you think it may be safe to remove the restraints

Remember to tell the nurse when you leave your child’s room for any reason.


This information is of a general nature and is not intended to serve as a substitute for the advice of a physician or other qualified health care provider. ©2021

(757) 668-7000

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