Restraints

PassionMedic

PassionMedic

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My partner has admittedly stated that he has difficulty tying and securing restraints on patients. Which got me thinking; what type of knots do you use to secure your restraints? Slip knots? Hitches? My partner secures them, but can't get them off without shears. Hoping to help him learn one more thing before I move off his shift at the end of the year.


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This is exactly what I do, but I figured before preaching my way, I would try and see what others use. Thanks :)


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Velcro straps...
 
When I worked on the ambulance many seasons ago, I used the multi-ply velcro straps also. Both of the ED's I've worked in use a locking variant of the same thing. Once it's applied, it's nearly impossible to remove. Generally I prefer soft restraints like the ones above, partially because the assessment interval is longer... I've been struggling with an easy way to secure that tail but until I saw this particular method, I've not had much luck. Next time I get to apply these restraints, I'll try to remember how to do it. It's the first part that I always seem to forget, leaving me with doing a slipped hitch. This looks much easier! Thanks!
 
Since I use triangle bandages, I just cut them. It's not like I am going to be using them again anyway.
 
I use the knot shown, without the final finish, even on cravats.

Reasoning? One less thing to fight with when it needs to come off. If soft restraints aren't enough, I'll just use chemical restraint. It's safer for everyone :)


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When I have to use Kerlex I will fold the total length in half, create a bight and put it around the pts wrists, then I usually do a slippery clove-hitch and finish it off with a quick half hitch on the stretcher (I learned it when I worked offshore in the oilfield and its the quickest/easiest knot I know). I have seen people restrain peoples arms with Kerlex directly around their legs so that the restraints can remain in place while moving the pt on and off the stretcher. But as @Ensihoitaja said above we have permanent velcro restraints on the stretcher that are quicker and easier to use.
 
VentMonkey said:
Click to expand...
This.

If you're using restraints with ties rather than Velcro, all knots should be quick-release, in fact in LA County (possibly all of California, I can't remember, it's been a while) it's the law. I hate when I see someone just stack square knots in top of each other. Also, you should only be using commercial restraints, not whatever is handy. But I suppose that's my lawyer father-in-law talking...

This was my preferred knot.
 
Double half hitch around the wrist with a cravat. Square knot around the frame
 
And when all else fails use duct tape
 
We have disposable soft restraints. They’re a huge pain. I like the Velcro ones.
 
Doesn't really seem to matter what kind of knot I put in Kerlix, always seems that fibers bind when you try to pull the release.
 
Versed, Geodon, and Ketamine.
 
Mmmhm. I do a lot of IM sedation and honestly don't really bother screwing around with Kerlix anymore. I probably should restrain them after they get Versed but with Ketamine that just seems unnecessary.
 
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