# Does your service provide you with restraints? (Poll)



## Fox800 (Dec 6, 2010)

Just curious. I've worked at a few (mainly BLS) services that did not provide any restraint equipment. The protocols would say things like "bedsheets are the only approved restraint" or "contact law enforcement for assistance". Looking back, I'm glad that I never ran into a call where I needed them. The services were also small-town, collegiate agencies. We mainly ran on healthy college-aged folks, didn't have a ton of psychs/ODs/combative diabetics.

Luckily, my current employer provides soft restraints. We can use them without OLMC (thankfully) but are expected to use them appropriately.


----------



## amberdt03 (Dec 6, 2010)

We carry soft restraints and can use them anytime we feel necessary without contacting Med Control. I've never had to use them. Anytime we've had a violent patient, PD was already onscene and had the Pt handcuffed.


----------



## TransportJockey (Dec 6, 2010)

All the services I've worked for provided some kind of restraints, usually soft Posey restraints. And we could use them, without calling, whenever we felt the need


----------



## Shishkabob (Dec 6, 2010)

Does Rocuronium count?  


As far as physical and not chemical restraints go, my current agency uses sheets / kerlex / police officers.  When I was at AMR, we had soft restraints.


----------



## MS Medic (Dec 6, 2010)

I voted no and we have to use other means, but that refers only to physical restraints. We carry haldol and versed and have protocols where we can give versed without contacting med control "if we feel we are in immediate danger" which gives us a loophole.


----------



## MS Medic (Dec 6, 2010)

Just like Linuss, we use kerlex for physical restraints.


----------



## reaper (Dec 6, 2010)

I use nothing but triangular bandages for restraints. 

Plus we have Geodon and Ativan for chemical restraint.


----------



## brentoli (Dec 6, 2010)

I've had a discussion before about a lock that you can fit around the release buttons on the cot straps. I can't remember if this was a real product or an idea for one. Anyone seen/heard of something like this?


----------



## rwik123 (Dec 6, 2010)

Boston ems has handcuffs (police ones)


----------



## MS Medic (Dec 7, 2010)

brentoli said:


> I've had a discussion before about a lock that you can fit around the release buttons on the cot straps. I can't remember if this was a real product or an idea for one. Anyone seen/heard of something like this?



That product is real. Saw an advertisement in JEMS. Basically, it is a hard plastic cube that slides over the buckle and is pinned in place when you buckle the strap and there is a slit over the buckle that you need a regular key to fit through to unlock the stretcher.


----------



## MS Medic (Dec 7, 2010)

rwik123 said:


> Boston ems has handcuffs (police ones)



wow that is interesting. The reason for soft restraints of some type or another is you can quickly release the pt with a set of shears or with slip knots in an emergency. In MS,we aren't allowed to transport anyone in LEO restraints unless we have a cop in the back.


----------



## Fox800 (Dec 7, 2010)

Soft restraints are preferred here but if LE wants the patient handcuffed, they're staying handcuffed (within reason, obviously not if it's interfering with urgent care). Our policy says that handcuffed pt's must have LE either riding in the back or "immediately available" i.e. driving right behind you.


----------



## Fox800 (Dec 7, 2010)

I'm worried about cravats getting really tight around wrists/ankles and cutting off circulation. I can easily see it happening.

We use Poseys. They work pretty well. If Poseys and midazolam don't do the trick, the next thing would be handcuffs from LE.


----------



## Bullets (Dec 7, 2010)

Yeah, cravats...
Just tie them into a prussik knot, only provides resistance when the patient pulls otherwise stays loose enough to not risk circulation cut off


----------



## Sam Adams (Dec 7, 2010)

MS Medic said:


> wow that is interesting. The reason for soft restraints of some type or another is you can quickly release the pt with a set of shears or with slip knots in an emergency.



If used appropriately and with knowledge so can cuffs. I believe the BEMS protocol states that once restrained, AND safe to do so, soft restraints are to be placed and the cuffs removed.


----------



## Sam Adams (Dec 7, 2010)

Bullets said:


> Yeah, cravats...
> Just tie them into a prussik knot



I just had to go reference my Boy Scout Handbook!


----------



## Rowdy (Dec 12, 2010)

longboard + reeves sleeve


----------



## ffemt8978 (Dec 12, 2010)

We have soft restraints and the never fail, always reliable duct tape.


----------



## feldy (Dec 13, 2010)

We use kravats and tie them so they wont be too tight unless the pt really pulls on them...usually after the first few tries, they stop resisting. I usually have to restrain once a shift (combative drunks). we dont have to radio in, just put them on and let the receiving hospital know in our radio report that restraints are on.


----------



## rwik123 (Dec 14, 2010)

Sam Adams said:


> If used appropriately and with knowledge so can cuffs. I believe the BEMS protocol states that once restrained, AND safe to do so, soft restraints are to be placed and the cuffs removed.



yeah i think your correct. The interesting thing about Boston ems is that they are "special" peace officers. They have a badge, cuffs, and even an asp baton. Its sort of a different breed of ems


----------



## JPINFV (Dec 14, 2010)

Citation required that Boston EMS is any sort of peace officer. Badges and cuffs do not make them police officers. 

Actually... any discussion about badges requires this clip.


----------



## dmc2007 (Dec 14, 2010)

rwik123 said:


> yeah i think your correct. The interesting thing about Boston ems is that they are "special" peace officers. They have a badge, cuffs, and even an asp baton. Its sort of a different breed of ems



IIRC Boston EMS has custody powers that isn't typically found in other EMS systems.


----------



## rwik123 (Dec 14, 2010)

dmc2007 said:


> IIRC Boston EMS has custody powers that isn't typically found in other EMS systems.



could you explain more? I'm just aware of the increased powers in general that my old instructor hinted upon having.


----------



## Sam Adams (Dec 15, 2010)

rwik123 said:


> yeah i think your correct. The interesting thing about Boston ems is that they are "special" peace officers. They have a badge, cuffs, and even an asp baton. Its sort of a different breed of ems



Different breed of EMS... kind of... Word on the street is, that when BPD needs someone restrained, in comes an ambulance. Further, what they carry are not ASPs, but simply flashlights....


----------



## rwik123 (Dec 15, 2010)

Sam Adams said:


> Different breed of EMS... kind of... Word on the street is, that when BPD needs someone restrained, in comes an ambulance. Further, what they carry are not ASPs, but simply flashlights....



Sorry, he must of been being sarcastic when he said that about the asp.


----------



## Phlipper (Dec 15, 2010)

Yes, we have restraints.  We use a quick upper-cut to the chin.  Works as well in the truck as it does in the bar.  

Pt: "@#$% you ya %&* sunnova @!$%! Get away from me you !@#$!"
EMS: "Now sir, we are trying to help you.  Please remain calm."
Pt: @#$%! You! (spits)
EMS: (POP!)  "Goodnight sir."


----------



## boingo (Dec 15, 2010)

Boston EMS does not have any police powers.  If we restrain a patient w/hard restraints they are transitioned to soft restraints if possible w/o risk to patient or crew.  Batons, Mace, Tasers, etc...are NOT allowed, and if I saw someone with any of the above we'd have a talk.  I'm sure there are people who conceal self defense items on their person however they are not authorized by any policy.  

As far as BPD using EMS to restrain people, yes and no.  If it is a patient, i.e. psych illness, intoxicated party in need of MEDICAL care, then yes, EMS is actively involved in the restraint, ideally w/police assistance.


----------



## HotelCo (Dec 26, 2010)

We have them, and can use them without contacting medical control.


----------

