RESTRAINTS

Submitted By..
T. Swetha
Bsc. Nursing
 INTRODUCTION

 All infants and children have physiological and

psychological needs to be mobile or movement. But
some procedure, limitation of movements is needed.
So, various types of restraints are used now a days.
 DEFINITION OF
RESTRAINTS
 A device which limits or prevents freedox of
movement.
 PURPOSES OF RESTRAINTS

 To limits the child’s movements during procedure

that may harm or injure the baby.

 To provide constant immobilization.

To facilitate examination of child or a procedure.

 To ensure child’s safety and comfort.
 PRINCIPLES OF RESTRAINTS

 Used only when necessary and never substitute for

observation.

Cannot be used on continuous bases.

If used, reason should be specified and explained to

child and parents.
Checked frequently to know not causing any side
effects.

Any required knot should be tied in a manner that

permits quick release.

 Immobile child should be replaced the lost activity.

 TYPES OF RESTRAINTS

1. Mummy restraints and modified mummy restraints.

[swaddle]
2. jacket restraints.
3. Elbow restraints.
4. Extremity restraints [ clove hitch restraints ]
5. Mittens.
6. Abdominal binders or restraints.
 MUMMY RESTRAINTS

PURPOSES
 immobilize the arms and legs for a period of time.
During examination and treatment of head and neck.
 During puncture of jugular vein.
 Procedure
 Take a blanket or draw sheet and spread it over the bed
or table.
 One corner of a small blanket is folded over.
 The infant is placed on the blanket with the neck at the
edge of the fold.
 Keep one hand of baby near the body and wrap the
baby’s body by holding the corner of the sheet and tuck
it under the body in opposite side.
 Now place another hand near the body and wrap
the child’s body by holding another corner of sheet
and tuck it.
 Now take the rounded sheet at bottom near the leg
and fold it towards the chest and tuck it upper level
of sheet or we can pin it at lower of sheet.
 It restrict all extrimities.
JACKET RESTRAINT

Pursoses
 To help the baby remain flat in bed in a supine
position.
 To prevent the baby falling from high chair.
 Chance of strangulation with jacket restraints.
 PROCEDURE
 A jacket made up of soft cloth and leather is used.
 This jacket has laces at the back and two long strips.
 The laces are tied at back and long strips tie at the side
below the rails under the mattress.
 Child can sit and sleep in supine position while wearing
jacket.
 It can use on chair also.
ELBOW RESTRAINTS

PURPOSES
 To keep the elbow in extended position so infant
can not reach the face.
 After the surgery of child’s face and head such as
cleft palate repair.
 During in eczema and skin disorder.
When introducing any Iv cannula.
 EXTRIMITIES RESTRAINTS
[CLOVE HITCH RESTRAINTS]
 To immobilize one or more EXTRIMITIES.
 Same as elbow restraints.
 PROCEDURE
 first apply the cotton pad over the wrist, ankle to
provide comfort.
Prepare a figure of ‘eight’ by the bandage and place
it on the wrist or in the ankle and tie the bandage by
knot.
Knot should not be too tight or too loose.
 Child can remove the knot if it is too loose.
 Too tight knot can interface on blood circulation.
Finally tie it into the bed not in the side rails.
MITTEN RESTRAINT

Used for infants to prevent self injury by hands in

case of burns, facial injury or operations, eczema of
the face or body.
PROCEDURE
 The hand can be wrapped by gauze or hand can
be put in a bag like pouch and tie it properly at the
wrist of child.
 Keep the mitten soft and it should not interfere
circulation .
ABDOMINAL RESTRAINTS

 To maintain supine position

 keep in mind the child respiratory movements
should be observed.
Feeding should not be inhibited.
 Infants, toddler and preschooler.
 SIDE EFFECTS OF
RESTRAINTS
Injury to the brachial plexus.
Sore or gangrene.
Loss of energy.
Dislike the hospital and health team members.
Physiological loss of muscular strength and flexibility.
Psychological hazards and inability to motor and
psychosocial skills.
 NURSING MANAGEMENT

 Restraints is necessary at time to examination, to

facilitate procedure and treatment, to protect infants
from harm or injury.
 Explains the restrains procedure, purpose to both
the parents and child. This restraints explain by the
procedure and demonstration of doll or ect.
 Stimulate the baby during restraints or give
diversion so baby don’t feel helpless and loneliness.
Restraints pull effectively so respiration and circle
ulation does not interfere.
Sufficient padding must be used under the extremity
restraint.
 Periodically, at least every two hours the child should
be removed from the restraint .
 Before the restraint are reapplied the child’s
position should be changed to improve physiological
function.