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By Julie Stevenson RNMH/RNLD DIP.N. Physical restraint & De-escalation techniques. This is only a demonstration and should not be used in the work place without appropriate training, Prevention is the best form of management
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By Julie Stevenson RNMH/RNLD DIP.N Physical restraint & De-escalation techniques
This is only a demonstration and should not be used in the work • place without appropriate training, • Prevention is the best form of management • Physical restraint is only to be used when all other options have failed. • Call for assistance. • Restraint is not a punishment. • Use diversion techniques. • The law states we must use “reasonable” force. • During restraint ALWAYS check the condition of the patient,A.B.C. • In 1995 Zoe Fairly a 21 year old with a learning disability was restrained by 4 staff for over 30 minutes =died of positional asphyxia. • In1997Roger Sylvester age 30 was restrained by 8 staff=died of positional asphyxia. • In 1998 David Bennets heart stopped during restraint. • In 2000Michael Goldwaters heart stopped during restraint. • Between 1991 &2009 there were 22 deaths in the UK as a result of prolonged restraints.
Scenario 1 • Someone shouting “I am going to kill you“ • Demonstrate low level holds to seating & de-escalation.
Scenario 2 • Aggressive patient attack…low level hold to figure of 4 hold to lowering to the floor hold forward position and turn over.
Scenario 3 • Aggressive attack…low level hold to figure of 4 hold to lowering to the floor ,backward position.
Scenario 4 • Strangle hold against a wall…breakaway
Scenario 5 • Strangle hold during struggle on the floor. breakaway.
Effective communication is essential in the management of Violence & Aggression. • Behaviour is a way of communicating. • Always de-brief with patients &staff. • Document what happened Before, During and After the event noting times dates people involved, injuries sustained.
Reflect…… • Do not take the event personally. • Try to remain calm work in collaboration with the Multi –Disciplinary team. • Explore options, care plans and ways of dealing with stressful or aggressive situations. • Remember it is also stressful for the patient. • Any questions? THANK YOU