Administrative

Policy: 183

Emergency Restraints

Procedure:

The Marion-Dillon County Bd. of DSN (MDCBDSN) to recognizes that from time to time MDCBDSN Staff will need to use emergency restraints in order to stabilize a critical situation. In order to comply with this, staff will receive training in the appropriate agency approved crisis intervention. It is also recognized that the preventive measures contained in the crisis intervention as well as those in Positive Behavior Supports will be utilized to de-escalate the situation before it becomes critical.

Emergency Restraint Procedures:

1. All direct-care staff and other staff as deemed appropriate will receive training in the agency-approved crisis intervention.
2. All attempts to prevent or de-escalate before the behavior happens will be made.
3. Should a restraint be necessary it shall be done in accordance with trained techniques.
4. A restraint should only be used as a last resort and will not be used unless the consumer is continuously aggressive and is a constant risk to themselves or others.
5. A restraint shall not be used as a punishment and shall not be included in a behavior support plan except as noted to be used in an emergency crisis situation. In this case the plan may spell out certain needs for that particular consumer. (ex. pacemaker, prone to seizures, type of restraint, etc.)
6. The amount of force used in a restraint should be only the amount necessary to control the consumer. Example if the consumer relaxes then the restraint should be relaxed.
7. The amount of time of the restraint should not go past the time allowed in the crisis intervention training or as dictated in the behavior support plan.
8. When possible two staff should be involved should a restraint need to be used.
9. Staff should monitor the amount of "distress" the consumer is under during the restraint by recognizing signs of distress. Signs of distress could be shallow breathing, flushed complexion, bluish tint to fingernails, seizures, vomiting, difficulty breathing, discoloration, swelling, etc. (crisis intervention trains on all the signs of distress). These signs could denote a serious problem that may require medical attention. In this case, staff will need to follow emergency protocol per their training in First Aid and CPR. Once the situation is stabilized staff will contact either the Agency Nurse(s) concerning the signs of distress, and/or 911 if the consumer is unconscious, unresponsive, seriously injured or has difficulty breathing. Staff will immediately report to their supervisor to inform them of the situation and any medical attention given or needed who will in return report up the chain of command as necessary.
10. Once the situation is under control and the consumer has stabilized staff will record the event on an incident report, (log book if applicable) and a restraint form and submit to their supervisor as soon as possible.
11. It is expected that should a restraint be necessary as outlined above that staff will intervene as they are trained. Doing nothing in a crisis situation could be considered "neglect;" therefore, staff must intervene as necessary in a crisis situation and with their best intentions, do what they have been trained in order to control the situation.