Q We are trying to be a restraint-free unit, but when a patient constantly reaches for their endotracheal tube, it is tempting to apply restraints. What other strategies can we use to prevent self-extubation?

A Michele C. Balas, PhD, RN, CCRN-K, and Audrey Brockman, BSN, RN, CCRN, reply:

Physical restraints play a highly controversial role in the care of critically ill patients. Proponents contend that physical restraints are necessary to protect patients from the harm associated with self-extubation, accidental device removal, and falls, and that they prevent injury to health care staff if a patient should become combative or physically aggressive. However, prior studies exploring physical restraint use and outcomes among critically ill patients do not support this belief; many paradoxically report that physical restraints are actually associated with higher rates of the adverse events that their use is intended to prevent. Opponents argue that, in the absence of...

You do not currently have access to this content.