What are some alternatives to physical restraint in inpatient and​ emergency settings?

Physical restraints are always the last resort in maintaining safety in any setting when behaviors are so out of control that no other option remains (ordered by MD/DO/APRN/PA). Keen observation of patients who have come in for the care of unstable psychiatric needs is essential, as monitoring them for agitation, impending self-harm, and risks of impending violence may prevent instances of behavior which is unacceptably uncontrollable. Before utilizing restraints​, clinicians should attempt to de-escalate patients verbally if possible. Patients may next be offered medication orally to assist them in calming (ordered by MD/DO/APRN/PA) or they may require emergency medication administered by injection if unable to consent to oral medication. Patients may be offered time to sit quietly in a monitored space with staff observing them 1:1 while they calm.


Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia: Lippincott, Williams & Wilkins.

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