Keywords: cardiac arrest, chemical restraint, ketamine, agitation, delirium (PubMed Search)
Patient restraint is a high risk, high liability encounter for all levels of emergency medical practitioners. Often, acutely agitated patients benefit from de-escalation. This can be difficult to achieve in a resource limited setting. McDowell et al (2023) performed a comprehensive review of patient restraint encounters. Their work describes risk factors linked to adverse outcomes. Specifically, highly agitated patients who are physically and chemically restrained can experience clinical deterioration. The review also highlighted risks to EMS clinicians as well such as: needle stick, physical inury, and downstream litigation.
Patient restraint represents a high risk encounter.
McDowall J, Makkink AW, Jarman K. Physical restraint within the prehospital Emergency Medical Care Environment: A scoping review. Afr J Emerg Med. 2023 Sep;13(3):157-165. doi: 10.1016/j.afjem.2023.03.006. Epub 2023 Jun 9. PMID: 37334175; PMCID: PMC10276259.