Restraints

VIOLENT RESTRAINTS

1. Place restraint order immediately after restraint placement.

2. Sign face to face note immediately after restraint placement (.edrestraints or from the BPA after restraint order placed)

3. A new order must be placed every 4 hours for adults OR whenever the amount of restraints changes (e.g. you take one leg restraint off that was previously on).

4. New notes are not required for de-escalation of restraints, but new orders are (as above).

5. New Face to Face note is required if patient is in restraints after 24 hours (patients should rarely require violent restraints this long). 

NONVIOLENT RESTRAINTS

1. Place restraint order immediately after restraint placement.  

2. Sign face to face note immediately after restraint placement. A new order must be placed every 24 hours if not removed (yes, non-violent restraints have longer period for re-order than violent ones).

3. If patient requires escalation to violent restraints, follow the above Violent Restraints steps (including new face to face note). 

4. New notes are not required for de-escalation of restraints. 

5. New Face to Face note is required if patient is in restraints after 24 hours.

If you get a patient in sign out in restraints, make sure you know what kind of restraints and when the order will expire. 

To write a face to face note for restraints, please open a blank note and use the dotphrase .restraintonehourfacetoface . Complete and sign. As noted above, this should be signed immediately after restraint placement and face to face.  This should be a separate note from your ED provider note.