The use of physical restraints in neurologic patients in the inpatient setting

Neurologists are commonly asked to make decisions concerning the use of physical restraints on hospitalized patients. These decisions are determined within the context of medical risk to the patient, including falls and the disruption of medical therapies (eg, self-extubation, removal of nasogastric tubes), risk to the caregivers, and the wishes of patients and their families. Familiarity with the medicolegal issues involved, including regulations of the local hospital and governmental agencies, as well as current evidence concerning the efficacy and harms that can occur with these interventions, is paramount to determining whether to use devices designed to restrict patients' freedom of movement in order to control their behavior.