Pediatric emergency medicine trisk 4171 4171
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TABLE 126.8
EMERGENCY AGITATION MEDICATIONS
The Joint Commission analyzed cases of physical restraint and identified
several risk factors associated with patient deaths. Asphyxiation was
associated with excess weight being placed on the back of prone patients, a
towel or sheet being placed over the patient’s head to protect against spitting
or biting, and airway obstruction due to placing the patient’s arm across the
neck area.
A minimum of five trained staff are needed to restrain a patient, one to
control each limb and one for the patient’s head. For extremely violent or
agitated patients, the prone position, although more restrictive, is safer for
both the patient and the care provider. Physically restrained patients need
constant observation by medically trained staff. The Joint Commission
mandates documentation of patient’s vital signs, assessment of behavioral
status, and offering of food, water, and access to bathroom facilities at
regular intervals. These standards also mandate a face-to-face evaluation of
