Adverse effects associated with physical restraint.
OBJECTIVE
Restraint use is not monitored in the US, and only institutions that choose to do so collect statistics. In 1999, investigative journalists reported lethal consequences proximal to restraint use, making it a life-and-death matter that demands attention from professionals. This paper reviews the literature concerning actual and potential causes of deaths proximal to the use of physical restraint.


METHODS
Searching the electronic databases Medline, Cinahl, and PsycINFO, we reviewed the areas of forensics and pathology, nursing, cardiology, immunology, psychology, neurosciences, psychiatry, emergency medicine, and sports medicine.


CONCLUSIONS
Research is needed to provide clinicians with data on the risk factors and adverse effects associated with restraint use, as well as data on procedures that will lead to reduced use. Research is needed to determine what individual risk factors and combinations thereof contribute to injury and death.
Mohr
Wanda K
WK
Rutgers University, College of Nursing, Newark, New Jersey, USA. mohr@nightingale.rutgers.edu
Petti
Theodore A
TA
Mohr
Brian D
BD
D001237:Asphyxia / Q000209:etiology* / Q000401:mortality; D001921:Brain / Q000378:metabolism; D002395:Catecholamines / Q000378:metabolism; D017408:Guidelines as Topic; D006801:Humans; D008133:Long QT Syndrome / Q000209:etiology / Q000401:mortality; D010640:Phenothiazines / Q000009:adverse effects; D011595:Psychomotor Agitation / Q000188:drug therapy / Q000378:metabolism / Q000628:therapy*; D011619:Psychotropic Drugs / Q000009:adverse effects*; D012149:Restraint, Physical; D012206:Rhabdomyolysis / Q000209:etiology; D013927:Thrombosis / Q000209:etiology
D002395:Catecholamines; D010640:Phenothiazines; D011619:Psychotropic Drugs