>
> If a patient has been assessed by a senior A/E doctor as requiring no
> specific medical treatment for their aggressive behaviour, is there a place
> for physical restraint?
I do not think that the lack of underlying medical condition is
important. Even if there is an underlying medical condition there
may be a need for physical restraint, so why put this worry for staff
into the equation?
> At present we do this under medical and nursing
> supervision using security trained porters - in order to prevent self injury
> and injury to staff. This may require 2 or 3 porters over a considerable time
> while medical and nursing observation and assessment continues. I ask if we
> should not be using "Velcro" or leather restraints in these situations. There
> wouldn't seem to be a great deal of difference legally but perhaps there is.
>
I am always interested in the way that these situations are handled
during my home CME (watching ER). Physical restraints are used
very frequently. I guess we tend to use chemical restraint instead.
> Is there experience of scanning or searching of patients - on reasonable
> grounds? Once into the central area of our dept. a patient who gets out a
> knife - as happened recently - poses a threat to everyone. A gun was
> volunteered recently again in the central area.
>
Again. From USA experience that is the way in which we are
heading. I see no reason why not. I was amazed at beeing searched
on my way into the ER in Denver even though I was accompanied
by the unit's director!
Tim.
Timothy J Coats MD FRCS FFAEM
Senior Lecturer in Accident and Emergency / Pre-Hospital Care
Royal London Hospital, UK.
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