Preventing Patient Care. Because seat belts are so easy to release. Thoughts?

[Elias Kos]

Over the years of being on the Box I have consistently run into the same problem. Whenever a patient becomes combative due to (Confusion, Substance Related, Dementia etc.) the first thing they do is take their seat belts off.

By doing this I often find myself fighting with the patient and unable to give patient care. My question to you is there something that can be done to restrain the patient in order to help prevent them from hurting themselves (and also allowing faster patient care) and to increase the safety of the Medic.

Things can go 180 when your in the back of the box by yourself. Please let me know your thoughts and if this is something that you believe will increase the safety of the patient and the medic at the same time.

 

[NomadicMedic]

• Haldol.
• Versed.
• Etomidate followed by sux

...or, if you don't believe in better living through chemistry, there's always 2 or 4 point restraints.

 

[luke_31]

Turn the buckle over so it's not facing out. Gives you a few seconds to get a handle on the patient before the cage door is open. So to speak

 

[Tigger]

Turn the buckles upside down and make an x with the leg restraints. You should always use shoulder straps (sadly not everyone provides them), but especially so here.

Real limb restraints work better than kerlix. Chemical restraint works the best.

 

[rural medic]

North south with triangular bandages when you don't want to use chemical restraints.

 

[Elias Kos]

Turn the buckles upside down and make an x with the leg restraints. You should always use shoulder straps (sadly not everyone provides them), but especially so here.

Real limb restraints work better than kerlix. Chemical restraint works the best.

I definitely agree with you about chemical restraints being the best. What Im asking is if there is a need for something “like a seatbelt that doesn’t release” and holds the patient in which gives you time to pull up chemical restraints. The scenario I am imagining is being along in the back on the way to the hospital.

 

[Elias Kos]

Turn the buckle over so it's not facing out. Gives you a few seconds to get a handle on the patient before the cage door is open. So to speak

All these are great ideas with a handful of people in the back or with plenty of time which you don’t have while the patient sits there and struggles. You spend most of the time attempting to administer patient care but instead your time is spent on keep the patient on the stretcher while you do everything else.
I don’t believe I am exaggerating how difficult it can be with a patient that won’t sit still and there is literally nothing holding them down. I wish the seat belt technology would incorporate something to help restrain the patient but ONLY when needed for obvious reason.

Stretcher technology has increased steadily over the years while the straps are over 60 years old.

 

[luke_31]

Most protocols already require restraints to be quick release with most not allowing anything with a key. Seatbelt so on the stretcher would be considered a form of restraint and thus you have the same dilemma of the patient can get out too easy. There is no simple answer for replacing the stretcher seatbelts the best that could be done is restraining the arms and legs as others have said short of chemical restraint. You should also do your best to anticipate if a patient will need restraints and apply them before moving, but it won't always be possible and if needed you could always call for assistance and pull over so your partner could help till additional resources arrive.

Also I've been in back many times with patients that come unrestrained it's not the easiest thing to do but restraining a person who escapes from restraints is possible. You won't ever anticipate every situation but jumping out of the ambulance if it becomes unsafe is an option (just wait for your partner to stop first).

 

[squirrel15]

There's also buckle guards you could use. Might have to purchase yourself but they can be kept in a pocket, the back of the gurney, or somewhere in the back of the rig. Only downside is, I believe its considered a restraint

 

[JPINFV]

In other news today, a conscious patient burned to death after the ambulance he was in was hit by a car and caught fire. Unfortunately, the patient was locked in using seat belts that wouldn't release, so he was unable to escape.

 

[Jim37F]

I'd hate to have a locking pair of seat belts lock up on me just as I go to unbuckle them to move a critical patient from the gurney to the hospital bed......

 

[medicdan]

http://www.jems.com/articles/2014/08/buckle-guards-now-available-emt-stretche.html

 

[Tigger]

All these are great ideas with a handful of people in the back or with plenty of time which you don’t have while the patient sits there and struggles. You spend most of the time attempting to administer patient care but instead your time is spent on keep the patient on the stretcher while you do everything else.
I don’t believe I am exaggerating how difficult it can be with a patient that won’t sit still and there is literally nothing holding them down. I wish the seat belt technology would incorporate something to help restrain the patient but ONLY when needed for obvious reason.

Stretcher technology has increased steadily over the years while the straps are over 60 years old.

We all know exactly what you are talking about. Either figure out which patients need to be restrained prior to transport or have your partner pull over and help. Seatbelts do not do a particularly good job of keeping combative patients on the cot even when the buckles remain fastened.

 

[Rialaigh]

I have utilized a reeves sleeve on numerous occasions even if I didn't think the patient was going to act up on the way in, I used it proactively just in case...it works absolute wonders on being able to keep a patient fairly still and on the stretcher without compromising airway, breathing, or excessive pressure on joints or at over vascular flow points.

Chemical restraint is the best period if the patient really necessitates a restraint, however given I have no chemical restraint on standing order for these types of patients I tend to utilize a reeves sleeve frequently just in case.