European Violence in Psychiatry Research Group Restraint Catalogue
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In order to promote good practice, the physical restraint techniques used by nurses and others need to be known, named, defined, and subjected to critical scrutiny. Too often the techniques taught by trainers or by training organizations are concealed or undeclared, perhaps out of a wish to retain ownership of them, or out of a wish to keep control over their application. However this secrecy prevents research; hinders sharing between different trainers and training organizations; undermines any debate or the development of national or international protocols; and handicaps the development of the safest possible methods.
In these web pages we have therefore collected together all the techniques we have been able to discover which are taught as part of a variety of 'control and restraint' courses available in different countries. We have systematically arranged and named these and provided alternative nomenclatures that we are aware have some common currency. By doing so we hope to encourage interactive dialogue and sharing of good practice. If you know of additional techniques, or have further information about the ones we have portrayed, please contact us and we will make sure your knowledge is shared.
Physical restraint is a controversial topic that arouses strong emotions and provokes heated ethical debate. We hope these pages will play a small part in facilitating informed debate through dispelling some of the general myths, misinterpretations and secrecy around restraint practice.
The authors of these pages are not in a position to endorse any of the techniques depicted. We do not currently know if any are better, more effective, or safer than any others (but see warnings below). Nor do we know which techniques are safer or more appropriate to apply to the elderly, children, or those with physical disabilities. We do believe that to be used at all safely or effectively, people using these techniques require training and practice. Simply viewing these pages is no substitute for that training and practice.
Certain restraint methods have been associated in the literature with sudden death of the person being restrained. In particular, neck holds, body weight being placed on the subject's upper torso, and the placing of obstructions over the subject's mouth or nose. These methods should therefore not be used as part of any restraint.
Restraint of the subject in a face down position, in particular with the legs bent backwards as in the 'figure of four leg lock', has also been associated with increased risk of untoward outcome. Alternative techniques should therefore be used when possible.
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