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Pediatric Patient Restraints and Other Alternatives (5435)

Pediatric Patient Restraints and Other Alternatives (5435) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Pediatrics, Parenting


Pediatric Patient Restraints and Other Alternatives
What Family Members and Friends Need to Know

Caring for a child who is in the hospital can
be hard at times. A child may have tubes,
intravenous lines (IV’s) or other devices that
should not be touched or moved. A child
may not be able to understand or cooperate
with the need to not touch or remove the
tubes or other devices. Children in the
hospital may be afraid, confused or receive
medicines that affect the way they act. They
may be at risk of hurting themselves by
pulling on tubes. It can be very hard for a
young child not to explore and play with
objects around them, because touching and
playing with objects are ways that children
learn about their world.

While no one wants to see children in
danger, the solutions are not simple. Years
ago, nurses and doctors quickly placed
confused and combative children in
restraints to assure safety. Today in our
hospital, restraints are only used after less
restrictive options have been considered.

What You Can Do to Help Your

Every effort is made not to place restraints
on your child. Your nurse will assess your
child and ask for your viewpoint. You can
help this effort by doing the following:

ξ Bring in items familiar to your child,
such as photos of parents, siblings
and pets; stuffed toys, favorite
blankets, or anything that your child
may hold for comfort.
ξ Keep to your child’s daily routine
and rituals as much as you can.
ξ Help your child maintain the ability
to walk (when possible).
ξ Keep your child busy with activities
right for your child’s age, such as
holding and rocking infants or
ξ Have a familiar adult at the bedside
to explain and re-explain things to
your child.
ξ Talk to and soothe your child.
ξ Keep a close eye on your child at all
times. Children, especially younger
children and infants, move very
quickly and may hurt themselves or
pull out a tube in seconds.

The most important thing you can do is to
talk with the team of people taking care of
your child. You know your child best and
can understand his or her needs which is
very helpful in planning care. By talking
with the health care team, you will know
about the treatment plan for your child.

As much as we try, it is not always possible
to keep a child restraint-free. At times,
restraints are the best choice. The rest of
this handout helps to answer common
questions that families often have.

What are Restraints?

Restraints are devices that restrict movement
to prevent injury to the child. “No-No”s are
padded devices in the form of tubes which
are placed on a child’s arms to prevent
bending the arms and pulling out IV lines or
objects on the face or head. If the No-No
does not work, soft wrist restraints may be
used to tie a child’s arms down to keep from
pulling on tubes or dressings.

Why Use Restraints?

When children are confused, afraid or very
young, they may be a danger to themselves if
not restrained. Restraints limit movement
and loss of tubes or dressings. At times,
restraints can help nurses and doctors
provide care.

How Long Does a Child Need

The need for restraints is continually
assessed for every patient. As a child
becomes less confused or their condition
improves, the staff will try to remove the
restraints. When the restraints are off, family
members or staff may need to be present to
remind the child not to touch tubes. The
staff will work with you to help you
understand how you can be most helpful.

Who Decides to Place Restraints?

The decision to restrain is made by members
of your child’s treatment team. This
includes doctors and nurses. A family
member is consulted whenever possible.
Restraints are used as a last choice. Keeping
your child safe is our major concern.

How Can I Be Sure My Child is
Safe While in Restraints?

Nurses and others will check the child’s
safety and comfort every hour. The hospital
has policies on caring for children in
restraints. The staff is specially trained to be
sure all children in restraints are closely

What Do We Do to Assure the Best

When restraints are used, it’s important to
let families know why they are being used.
Children will sometimes fight against
restraints and want them taken off. This is
when it’s helpful to talk with the child about
what the child can do to have the restraints
removed. Your nurse will talk with you
about specific behaviors the child needs to
do in order to have the restraints removed.
For example, when children can follow
simple directions and leave tubes, IVs, and
other devices in place, then restraints may be

What Does It Feel Like to Be

Children vary in their feelings about being
restrained. Some children and infants are
unaware of the restraints. Other children
may feel lonely, isolated, angry, fearful or
humiliated. You may hear your child ask,
“What did I do wrong?” Your child might
feel like the restraint is a punishment. You
can help your child by saying the restraint is
temporary and that he did not do anything

How Can I Help My Child while
Restraints Are in Use?

ξ When you can, it is best to stop by
the nurse’s station before entering
the patient’s room for the first time.
This will give the nurse a chance to
briefly tell you about restraints and
why they are being used. This is a
good time to ask questions.

ξ Sometimes, restraints are used
because a child is confused.
Therefore, it’s best to try to do things
that help the child become less
confused. It is helpful to tell them
o Who you are
o What day it is
o Where they are, and
o Why they are restrained.

ξ Ask questions that require brief or
one-word answers. This helps a child
to feel more in control. Simple,
short answers to questions also help
a child to understand your response.

You also need to be aware of your safety and
the safety of the patient. No medicines or
sharp objects should be left within reach of a
child. Let the nurses know before leaving
the child alone. Children and infants can
move very quickly and fall from a crib or a
bed, even with a parent right beside them.

Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright ©2/2017. University of Wisconsin Hospitals
& Clinics Authority, All Rights Reserved. Produced by the Department of Nursing. HF#5435.