Restraint policy

NAEMS Restraint Policy

1. Restraining The Combative Patient By: Daniel Howell EMT Director of Training Newark-Arcadia Emergency Medical Services

2. Objectives Review NAEMS new policy on use of restraints. Determine when/when not to use restraints Review different techniques to avoid using restraints. Review standards for documentation when restraint’s are used.

3. NAEMS Restraint Policy In 2016 NAEMS Operations Staff developed a policy regarding the use of physical restraint after an incident involving an NAEMS staff member took place. To protect staff, as well as patients, the policy was developed and will go in affect as of tonight.

4. NAEMS Restraint Policy If no officer is present and restraints are needed; - Crew members must call for assistance. This meaning a police response (expedited if needed), Assistance from another crew, or med control for possible sedation orders. - IF needed, Crew members shall remove themselves from the situation. Reminder, NEVER block a path of egress as it could hinder your safety. - Restraints must be used in accordance with FLREMSC and State Protocols.

5. NYS Behavioral Emergencies Protocol (M-4)

6. NYS Behavioral Emergency Protocol (M-4)

7. NAEMS Restraint Policy If an individual becomes aggressive during transport, The driver shall immediately pull over, and request a police response to their location. If the individual attempts to remove themselves from the ambulance the crew shall allow that individual to do so. Crew members shall advise dispatch of direction of travel, and description of individual. If the crew members are unable to calm patient, they shall remove themselves from ambulance, making sure to take the keys out of the ignition.

8. NAEMS Restraint Policy At the hospital: Crew members who placed the restraints shall remove the restraints. Be sure the presence of Police or Hospital Security prior to doing so. Also, do not be hesitant to ask for Physician to order sedation prior to moving them from your stretcher to hospital bed. If the restraints were placed by Police, EMS shall utilize the “Hands off” Approach and allow the Officer and Hospital Security to remove the restraints. If for any reason Law Enforcement, Hospital Staff, Or Security appears to needs emergent assistance, they must ask prior to NAEMS staff assisting.

9. NAEMS Restraint Policy If for any reason Police need assistance restraining an individual, they must ask for assistance prior to NAEMS staff assisting them. NAEMS staff shall then document the name of the officer asking for assistance in his/her PCR. If NAEMS staff finds themselves in danger, they shall use any means necessary to remove themselves from the situation. At no time shall NAEMS staff prolong an altercation with any individual.

10. NAEMS Restraint Policy All crew members must complete an incident report on EMS charts following use of restraints. A critique involving Operations Staff will take place if deemed necessary. If an NAEMS member is injured, or believes excessive force was used by any personnel involved in the restraint process, that person must contact Operations Staff IMMEDIATELY!

11. NAEMS Restraint Policy NOTE: NAEMS Operations Staff does understand that there will be extenuating circumstances where this policy may not be followed. If this occurs you must contact a member of the Operations Staff Immediately. NAEMS Strives to provide excellent and compassionate care to all patients. Avoidable injury to a patient during the restraint process will not be tolerated. With that being said, we also take the safety of our members very seriously. We all must do our best to maintain a professional and compassionate attitude at all times, and we must keep ourselves, our partners, and our patients safe.

12. When/When Not to use physical Restraints A 27 year old male who is suicidal, speaking to ems in an aggressive manner, stating he will hurt anyone who tries to help him. Becomes even more agitated when ems tries to talk to him. Restraint or No Restraints? What are the steps you’d take?

13. When/When not to use physical restraints 50 Year old female feeling depressed. Has admitted to using drugs. Appears anxious. Patient is screaming when you arrive. Restraints or no Restraints? What are the steps you’d take?

14. Documentation Standards Follow all Documentation Standards already set forth by the QA/QI Department. Document the time physical restraints were applied and removed, what type of restraint was used ( ie Sheet, Cravats, handcuffs, ect ) If patient is sedated, ALS Providers must document as they would with any other medication administration. If patient is restrained by an Officer, The Officers name must be documented in the EMS Chart. Also note that if a patient is restrained using handcuffs, it must be with his/her hands in the front, and the officer must ride in the ambulance to the hospital.

15. Questions?