UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE
TITLE: PAPOOSE BOARD RESTRAINT (Pediatrics)
Effective Date: April, 2004 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education
Reviewed March, 2005 Nov., 2007 May 2009 October 2011
PURPOSE: To provide guidelines for the safe restraint of a pediatric patient during a
procedure (IV starts, injections etc) at UWMF Clinics.
DEFINITION: Papoose restraints are used to ensure the safety of a child during
POLICY: The clinical staff will utilize the following guidelines to safely use a papoose
restraint on a UWMF patient (child) during pediatric procedures.
SUPPLIES: Papoose Board with Velcro Straps, provider’s order, patient’s record, pen
1. Check provider’s order and clarify any inconsistencies.
2. Wash hands and gather equipment.
3. Introduce yourself
4. Identify the patient by verifying the name and date of birth.
5. Explain procedure and the use of the papoose board to the patient & parents/guardian.
6. Provide good light and provide privacy by closing curtains or door.
7. Place the papoose board on a flat surface (exam table).
8. Secure child to the papoose board with Velcro restraint straps around the extremities
and chest. (See diagrams on page 2).
NOTE: You may wish to have another staff person assist you in securing the child.
This will help the restraint process go smoothly and quickly for the child.
Generally it is not a good idea to have parents/guardian assist in securing the child.
NOTE: DO NOT leave the child unattended once child is secured on papoose board.
9. Assist provider with procedure.
10. Reassure child and parents/guardian during the procedure.
11. Monitor extremities every fifteen minutes during procedure for color, mobility and
12. Remove Velcro restraint straps at the end of the procedure.
13. Return child to parents/guardian using positive comments and praise.
14. Wash hands
15. Document in the patient’s electronic medical record the following:
Type of procedure
Observations of the child and parents/guardian
Child’s response to the procedure and papoose board; including
documentation on items such as the coloring of extremities and mobility after
16. Wipe off papoose board after each use with UWMF approved disinfectant.
NOTE: DO NOT use alcohol for cleaning.
17. Spot clean fabrics with UWMF approved disinfectant or launder if overly soiled.
NOTES: Straps can be washed in Ivory soap, rinsed in warm water and air-dried.
Order an extra set of straps, so papoose board is always ready for use.
Janice Sydow, Registered Nurse, East Towne Pediatrics
LaVay Morrison, RN, BSN, Clinical Staff Educator
Ronnie Peterson, R.N., M.S., Manager of Clinical Support
Perry, A.G. & Potter, P.A. (2002). Clinical nursing skills & techniques. (5
Louis, MO: Mosby.
Perry, A.G. & Potter, P.A. (2009). Fundamentals of nursing. (7
ed.). Hall, A. &
Stockert, P.A. (Eds.). St. Louis, MO: Mosby Elsevier.
Kowalak, J. P. (Ed.). (2009). Lippincott’s nursing procedures (5
ed.). Ambler, PA:
Lippincott Williams & Wilkins.
Medical Director Date