12.06 Papoose Board ‐ Pediatric Clinics
Category: UWHC Departmental Policy
Policy Number: 12.06
Effective Date: December 4, 2013
Section: Clinic Specific (Ambulatory)
To establish a process for clinic staff to safely secure a pediatric patient on a Papoose Board for patient safety
during a procedure.
A Papoose Board may be used for infants and toddlers for selected procedures with continuous monitoring.
A. Papoose Board
B. Velcro straps
C. Sheet or blanket
IV. CARE OF EQUIPMENT
A. Wipe off Papoose Board after each use with University of Wisconsin Hospital and Clinics approved
B. When soiled or direct contact with the patient, wash velcro straps in mild soap and water, rinse and dry.
A. Obtain Order for the restraint.
B. Cover the Papoose Board with a sheet or infant blanket.
C. Explain the plan/procedure to the parent and child.
D. Place the Papoose Board on a flat exam table.
E. Use a sheet or blanket placed beneath the board, to secure arms and legs of the child to the Papoose
F. Secure the child to the Papoose Board with the velcro restraint straps around the extremities and chest.
G. Reassure the child, use distraction and soothing/comfort measures during the procedure, as
H. A clinic staff member should be present at all times to monitor the safety of the patient while a Papoose
Board is being used.
I. Clinic staff will monitor extremities every fifteen minutes during the procedure for color, mobility and
J. Comfort child and return child to parent as quickly as possible with praise and positive comments.
K. Document procedure, observations, monitoring, and child's response to the procedure.
Nursing Patient Care Policy 13.23 - Application of Physical Restraint
VII. REVIEWED AND APPROVED BY
Pediatric Clinic Managers
Quality and Safety Improvement
Ambulatory Policy and Procedure Committee
Deborah D. Tinker, RN, MS, Director, Ambulatory Nursing