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Restraint use in the elderly emergency department patient
Connie Swickhamer1, Cameron Colvig, Shu B Chan
1Emergency Medicine Residency Program, Resurrection Medical Center, Chicago, IL 60631, USA.
The Journal of Emergency Medicine
|January 31, 2013
Summary
Elderly patients in the Emergency Department (ED) requiring physical or chemical restraint did not experience adverse outcomes. However, those initially home were unlikely to return home after restraint use.
Area of Science:
- Geriatric Medicine
- Emergency Medicine
- Patient Safety
Background:
- Elderly patients in the Emergency Department (ED) often present with altered mental status or other conditions necessitating physical or chemical restraint for safety.
- Restraint use in this vulnerable population requires careful consideration of potential risks and outcomes.
Purpose of the Study:
- To examine the outcomes of elderly patients who received physical or chemical restraint in the Emergency Department (ED).
- To assess the safety and efficacy of restraint methods in older adults within the ED setting.
Main Methods:
- A 2-year retrospective study was conducted in an urban community teaching hospital's Emergency Department (ED).
- Included were patients aged 65 years and older who were physically restrained during their ED stay and subsequently hospitalized.
- Data collected included patient demographics, restraint indications and types, duration, adverse events, diagnoses, disposition, and hospital length of stay.
Main Results:
- Of 83 restrained elderly patients, 56.6% were nursing home residents, and 32.5% required intensive care unit admission.
- No significant differences in outcomes were observed between patients receiving physical restraint alone versus combined physical and chemical restraint.
- Patients initially admitted from home were significantly less likely to be discharged back home after restraint use.
Conclusions:
- Physical restraint use in elderly Emergency Department (ED) patients, even in combination with chemical agents, was not associated with recorded adverse outcomes in this study.
- Elderly patients requiring physical restraint in the ED, particularly those who initially presented from home, faced a diminished likelihood of returning to their homes post-hospitalization.
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