Limb restraints can be physical (or psychological) restraints that inhibit an individual's movement in their

arm In human anatomy, the arm refers to the upper limb in common usage, although academically the term specifically means the upper arm between the glenohumeral joint (shoulder joint) and the elbow joint. The distal part of the upper limb between the ...

s or

leg A leg is a weight-bearing and locomotive anatomical structure, usually having a columnar shape. During locomotion, legs function as "extensible struts". The combination of movements at all joints can be modeled as a single, linear element ca ...

s. The most common limb restraint is physical, whereby restraints are fixed to the individual in order to prevent movement of the limbs. They're most commonly used within the field of medicine. However, opposed to physical restraints, chemical restraints are forms of psychoactive medication that intentionally inhibit an individual's behaviour or movement.

Types of limb restraints

As a

medical restraint Medical restraints are physical restraints used during certain medical procedures to restrain patients with (supposedly) the minimum of discomfort and pain and to prevent them from injuring themselves or others. Rationale There are many kinds of m ...

, limb restraints are soft, padded cuffs which are applied to a patient to prevent the patient from causing harm to themselves or to others. The device consists of cuffs which are wrapped around the patient's

wrist In human anatomy, the wrist is variously defined as (1) the Carpal bones, carpus or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand; "The wrist contains eight bones, roughly aligned in two rows, known ...

s or

ankle The ankle, or the talocrural region, or the jumping bone (informal) is the area where the foot and the leg meet. The ankle includes three joints: the ankle joint proper or talocrural joint, the subtalar joint, and the inferior tibiofibular join ...

s, and straps that are attached to the frame of their bed or a

restraint chair A restraint chair is a type of physical restraint that is used to force an individual to remain seated in one place to prevent injury and harm to themselves or others. They are commonly used in prisons for violent inmates and hospitals for out of ...

. Limb restraints can be fabric, leather or metal. The most commonly used type of limb restraints are fabric restraints. If fabric restraints are inadequate to restrain a patient, leather or metal restraints can be used. In most places, legal restrictions apply to the use of restraints in clinical settings. The application of limb restraints on both arms and legs at once is sometimes known as a four-point restraint.

Leather restraints

Leather restraints are used for strong patients for whom soft restraints fail to prevent escape. They can be applied around the waist, or to individual limbs. All restraints require a physician's order to be applied. While fabric restraints can be applied by a nurse temporarily while awaiting for a physician's order in an acute care setting, leather restraints can only be applied if pre-authorized by a physician.

Metal restraints

Metal restraints are usually made of stainless steel. They are used for patients for whom fabric and leather restraints fail to prevent escape. But legally, they can only be used with a court order and with a member of law enforcement present within 500 feet without the use of an elevator or more than one flight of steps up or two down. Metal restraints are only permitted to be used on patients who are in legal custody or whose behavior in the health care setting is of a criminal nature (e. g. assaulting or making verbal threats of assault toward health care worker). Most jurisdictions have judges on call 24 hours who can issue court orders promptly when necessary.

Usage in treatment

Limb restraints are often used on a combative or disoriented patient who is using his/her arms or legs to strike at staff or others, to pull important medical apparatus, such as an IV tube or

catheter In medicine, a catheter (/ˈkæθətər/) is a thin tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. Cath ...

, out of their body,Handbook of Geriatric Nursing Care, Volume 236
p.552. or to otherwise interfere with their care. Arm restraints also become necessary when a patient must lie on his/her back at all times. Patients who may come in need of limb restraints include those who have suffered a

head injury A head injury is any injury that results in trauma to the skull or brain. The terms ''traumatic brain injury'' and ''head injury'' are often used interchangeably in the medical literature. Because head injuries cover such a broad scope of inju ...

, those recovering from

seizures An epileptic seizure, informally known as a seizure, is a period of symptoms due to abnormally excessive or neural oscillation, synchronous neuronal activity in the brain. Outward effects vary from uncontrolled shaking movements involving much o ...

(usually multiple ones), have been under

anesthesia Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), ...

for a long period of time, or those suffering from

mental illness A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...

dementia Dementia is a disorder which manifests as a set of related symptoms, which usually surfaces when the brain is damaged by injury or disease. The symptoms involve progressive impairments in memory, thinking, and behavior, which negatively affe ...

, or

side effects In medicine, a side effect is an effect, whether therapeutic or adverse, that is secondary to the one intended; although the term is predominantly employed to describe adverse effects, it can also apply to beneficial, but unintended, consequence ...

from their treatment.

Safety

Four-point restraints heavily restrict the movement of a patient, and may render the patient helpless when s/he needs to move in an emergency. Many facilities will hire a companion to watch a patient who is placed under four-point restraint.

Escaping restraints

Most patients who find themselves restrained naturally think they can free themselves by pulling hard at the restraints. But the restraints are made out of plastic mesh, which cannot be broken by being pulled with human strength. Other patients attempt to unfasten the restraints around the wrist, but find they cannot reach the fastener unless they have abnormally flexible joints. Some do manage to slip their hands through the cuff, though competent workers prevent this from happening. The easiest way to free oneself from restraints is to reach with one hand to the side of the bed, which is possible. There, the restraint is tied and can be easily untied. After freeing one arm, it is easy to use it to free the other. The patients who seem to know this the most are those who have previously worked in acute health care settings.

Other uses

Limb restraints are a

sexual fetish Sexual fetishism or erotic fetishism is a sexual fixation on a nonliving object or nongenital body part. The object of interest is called the fetish; the person who has ''a fetish'' for that object is a fetishist. A sexual fetish may be regard ...

for some people, and are used in some

BDSM BDSM is a variety of often erotic practices or roleplaying involving bondage, discipline, dominance and submission, sadomasochism, and other related interpersonal dynamics. Given the wide range of practices, some of which may be engaged ...

activities, such as in spread eagle bondage.

References

{{Health care Physical restraint