New Study Identifies ER Patients Who May Need Restraint

New Study Identifies ER Patients Who May Need Restraint

Though sometimes necessary, restraint in the ER could lead to adverse events for the patient. A new study has identified patients who may need restraint.

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Emergency rooms are at the frontline in a hospital that treats a wide range of patients.

ER doctors assess the medical conditions arriving for emergency treatment and determine if they need be treated at the ER or can be sent home, or if they need to be admitted to stay longer for further work-up and treatment. In the emergency room, doctor visits are often hurried and a number of important details need to be recorded.

These notes are accurately transcribed with the help of medical transcription services.

Sometimes, patients may have to be placed under physical restraint when being treated in the ER. New studies have highlighted the typical characteristics of patients who are admitted in the emergency room. Majority of patients restrained in the emergency room are either relatively young, predominantly male patients presenting with drug or alcohol use, or older patients, usually with severe medical complications. This is valuable information because there is a gradually growing number of behavioral emergencies and serious risks associated with restraint.

Behavioural emergencies in the ER are rising rapidly. A national estimate shows a 50 percent increase for behavioural disorders between 2006 and 2011, compared to an 8.6 percent increase in the total number of visits. Agitation is often related with behavioral ED visits, with 1.7 million events occurring naturally. Annals of emergency medicine researchers point out that the adverse events associated with restraint include blunt chest trauma, respiratory depression, aspiration, and asphyxiation leading to cardiac arrest. Another survey found that 66 percent of ER patients experienced severe psychological distress and lasting consequences in regard to care seeking behaviour after physical restraint. The researchers conducted the first large scale study to understand the kinds of patients who are restrained in the ER. Their study included 3,739 restrained patients from five hospitals. In the study they found that there were two groups of restrained patients with varied characteristics: 

The larger group accounted for two thirds of restrained patients with a median age of 39 and the smaller group had a median age of 64.

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The larger group had around 70 percent of men whereas the smaller group had 60percent of men.

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60 percent in the larger group had Medicaid coverage and 49 percent in the smaller group had Medicaid coverage.

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30 percent of patients in the larger group were black and 20percent in the smaller group were black.

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Majority of people, i.e. 8.9 percent, in the larger group were homeless and 0.9 percent were homeless in the smaller group.

According to the researchers, ER staff should take a cautious approach when deciding whether to restrain both kinds of patients. Another study showed that ER staff had

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strong sentiments of frustration and resentment towards patients with alcohol or drug use, psychiatric illness, homeless and frequent ED visits. The researchers said that there is a significant risk associated with restraining older patients.

The following are primary standards for restraints and seclusion of patients: 

Patient restraint or seclusion should be implemented safely, based on hospital policy as well as laws and regulations.

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Medical staffs should monitor restrained or secluded patients.

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Hospitals should have written guidelines for restrained or secluded patients.

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Use of restraint or seclusion should be documented

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Deaths linked to restraint

or seclusion should be reported to the Center for

Medicare and Medicaid services 

Staff should be trained in the safe use of restraint and seclusion.

There are many conditions that doctors treat in the ER and they play a crucial role in stabilizing critical patients. So many crucial medical notes are taken down in the ER, which are transcribed with the help of medical transcription companies into accurate medical reports. Such patient care documents serve also as valuable research material for researchers studying emergency room related issues.

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918-221-7809