The Pattern of Physical Restraints applied to the Mentally-ill in the Emergency Unit of a Tertiary Health Care Center in Nigeria.

Abstract

Background: Physical restraints are often used as part of the initial treatment of the mentally-ill, particularly for the uncooperative patient. This ensures safety.
Methods: This study examined the pattern of the use of physical restraints at the Accident & Emergency Unit of the University of Benin Teaching Hospital (UBTH). Consecutive patients were recruited as they presented with psychiatric emergencies over a 4 month period.
Results: A total of 20 patients had physical restraints applied on them during the study period. Males were 75% while females were 25%. Diagnostic groups found among the patients included Bipolar Affective Disorder current episode manic with psychotic symptoms (30%), Delirium (25%), Schizophrenia (20%), Acute polymorphic psychotic disorder without symptoms of schizophrenia (20%) and Dementia (5%). The reason for the use of restraints was restlessness in 60% of cases and aggressive behavior in 30% of the patients. Bandages were mostly used to achieve physical restraint (55%). Other materials included linen (30%), chains (10%) and ropes (5%). Four-point restraint (65%) was the commonest method used. The duration of the use of restraints included a day (50%), 2 days (40%), 3 days (5%) and 4 days (5%). Most of the patients (65%) had no injury resulting from the restraints.
Conclusion: In conclusion, the pattern seen in UBTH showed that physical restraints were applied when necessary for short periods due to its combination with pharmacotherapy. The expertise involved ensured that most patients do not sustain any injury.

Key words: Physical restraints, Pattern, Mentally-ill, Emergency.