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Cardiorespiratory consequences to hobble restraint

M Roeggla1, A Wagner, M Muellner

  • 1Department of Emergency Medicine, University of Vienna, Austria.

Wiener Klinische Wochenschrift
|May 23, 1997
PubMed
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Hobble restraint in the prone position significantly impairs cardiopulmonary function, decreasing vital capacity and cardiac output. The upright position is recommended to prevent adverse outcomes in patients undergoing mechanical restraint.

Area of Science:

  • Emergency Medicine
  • Physiology
  • Forensic Medicine

Background:

  • Mechanical restraints, including hobbles, are used in emergency psychiatric care, particularly when patients are brought in by law enforcement.
  • Sudden death has been reported in individuals subjected to hobble restraint.
  • The cardiopulmonary effects of hobble restraint require further investigation.

Purpose of the Study:

  • To investigate the cardiopulmonary response to hobble restraint in both prone and upright positions.
  • To assess the physiological impact of mechanical restraints on individuals.

Main Methods:

  • A randomized crossover trial involving six male volunteers.
  • Measurement of cardiopulmonary parameters after three minutes of hobble restraint in both prone and upright positions.

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Main Results:

  • No significant changes in cardiopulmonary parameters were observed in the upright hobble restraint position.
  • Prone hobble restraint resulted in significant decreases in forced vital capacity (39.6%), forced expiratory volume (41%), heart rate (21.3%), systolic blood pressure (32.3%), diastolic blood pressure (26.1%), and cardiac output (37.4%).
  • Prone hobble restraint led to a 14.7% increase in end-tidal carbon dioxide.

Conclusions:

  • Hobble restraint in the prone position causes severe impairment of hemodynamics and respiration.
  • The upright position for hobble restraint and frequent monitoring of vital signs are crucial to prevent potentially fatal outcomes.