Let's take a look here at applying
non-behavioral wrist restraints.
Now, wrist restraints are probably
going to be some of the most common
restraints that you're going to use.
So first of all you're going to use
and get your facilities wrist
restraints that they have on hand.
First, you're going to perform your
hand hygiene and position your patient.
Now make sure you place the limb in the
soft padded portion of the restraint.
That's the nice thing about most wrist restraints,
they have a little excess padding around the skin.
So it doesn't make it so hard or scratch
or tear up the patient's skin here.
Now, we need to fasten the restraint,
there's a little buckle on
top of that, that will connect
and then adjust the straps
to the correct tightness.
Now, notice here on the top of this image
there's a tail with the wrist restraint.
You're going to tighten this for
whatever size your patient's wrists are.
Now, it's really important
that it's not too tight,
so we perform a two finger circulation check.
So, all we mean by this, is we take two fingers,
slide it under the restraint
and if there's that much room,
we're good to go.
Now, we want to fasten the restraint to the bed
and remember, a non-moving part,
using a quick-release knot.
Now we can perform our hand
hygiene and document our procedure.
Let's take a look at
non-behavioral wrist restraints.
So when we're applying it, let
me show you a piece of equipment.
So this is what we call our soft wrist restraints.
So it comes a couple of different ways,
so I showed you earlier how
to do a quick-release knot,
but some wrist restraints
come with this end to it.
So notice how this buckles, so if I unbuckle this,
this is the piece that's going to go to the bed.
So let me show you that piece.
So this is really nice, because
this offers a quick unbuckle,
instead of a quick-release knot
like I had showed you earlier.
So this is the piece that's
going to go to the bed frame,
so really you'll just notice
here's the end of the buckle
and here's a piece and an opening as well.
So, I'm going to feed this through the bed frame
and remember a non-moving
part of the bed is essential.
Now I'm going to take my buckle
and put it through the small
loop on the restraint itself
and just feed this through.
So again, this is here and
we can remove this quickly
if needed with a buckle,
so now I'm going to apply my buckle, now
I've got this piece attached to the bed.
So let's take a look closer look
at the wrist restraint itself.
So, this also has a buckle,
to open this up on the patient.
So as you notice, this is a
really nice soft material,
this is really helpful, because when
it's around the patient's wrist,
it's not going to really excoriate
or tear up the patient's skin.
So now, also if you notice, there's a little
velcro piece we're going to open this up
and this is what we apply
around the patient's wrist,
so I'll do that now.
So I'm going to apply the wrist
restraint around the patient's wrist.
We've got this little velcro
piece that goes on top,
then I'm going to take that
other buckle and secure it.
Now, this is the piece that may need adjusted,
so you may have to adjust this for
the size of your patient's wrist.
So here's my buckle, I've latched that on
and I've tightened this with this tail.
Now, what's essential here, if you remember,
always perform your two fingers
finger circulation check.
So, I'm going to take my two fingers
and slide it under the wrist restraint.
See how I can get my two fingers underneath here,
that's really essential,
however if you notice, I can
almost put three fingers,
so this is a little bit loose
and I need to re-adjust.
I'm going to re-velcro and re-buckle.
So now, I'm going to take my
two-finger circulation check
and I can just barely wiggle
my two fingers underneath there
and that's the amount of tightness
we want around the patient's wrist.
Now sometimes the patient, as
you notice they're secured,
but there's so much slack, they can still
interfere and pull with medical treatment,
pull out their nasogastric tube for example
or their IV.
So sometimes, we may
need to pull up some slack.
So if you notice on your wrist restraint,
remember this is a piece to the bed
and this is the piece to the patient.
So to adjust the length, we
may need to take this piece,
by the buckle and pull this to make
it a little tighter for the patient
and to pull up some extra slack.
So now, we don't have quite so much freedom,
again, that's still quite a bit, so
we may need to adjust it some more
and we're going to pull this to where
we feel is appropriate for our patient.
So, let's look at the skill
"Applying restraint mittens".
Okay you may be thinking what are the mittens?
Well, let me show you.
Okay so this is a restraint mitten,
so it may look a little odd,
but this is really helpful
to keep the patient from pulling
out maybe their feeding tube
for example or pulling on an IV line.
This actually just really
places on the patient's hands,
so it keeps their grasp from grabbing a line.
Now, one thing to know in regards to mittens.
Now if I place this on my hand,
I can still freely move around right,
so these are great restraint alternatives.
However, any time that you put this on a patient
and then you have to affix it to the bed,
remember anytime the patient is
affixed to the bed with the restraint,
that's going to be the restraint, but
the mitten itself is not a restraint.
So just keep that in mind,
these are great alternatives,
but for this demonstration, we're going
to show you how to place on the mitten.
So now let's take a look at
what we're going to need,
well of course the restraint mittens themselves.
I just showed you one example,
now know that there are some variations to this,
so make sure you check with
your agency's equipment
and what you have at your facility.
So before we get started, make sure you perform
your hand hygiene and position
your patient comfortably.
Now, when we put the patient's hand in the mitten,
they're going to put their hand palm down.
Then we're going to separate the
fingers if the mitten has separators.
Some of these, like I said,
there's a variation to those
and there's little finger slots that
you can slide the patient's hand in.
Then, we're going to wrap the
strap around the wrist to secure it
and then we're going to secure it
with a fastener on the mitten itself.
Now, here's where we need to adjust
the straps to the correct tightness
and don't forget to make sure it's not too tight.
This is where we perform a
two finger circulation check.
What I mean by this again,
is taking your two fingers sliding it underneath
the mitten that we just secured
and make sure there's enough
room to slide into fingers
and again we do this to make sure
it does not impede circulation on our patient.
Now, we can fasten that restraint to
the bed using a quick-release knot.
And then once we've done this,
we'll perform our hand hygiene
and document the procedure.