ER patients shed light on the trauma restraints can bring

Numerous patients described being restrained during emergency room visits and the lasting negative effects the experience had on their well-being, according to research published Jan. 24 in JAMA Network Open.

Researchers with New Haven, Conn.-based Yale School of Medicine interviewed 25 patients who had been restrained in two urban ERs. Nine of the 25 patients reported negative feelings about restraint use and felt abandoned by staff, or that they lost their dignity and self-determination. Ten patients had mixed feelings, while another six said they had positive feelings — "the staff have got my best interest at heart"— or felt they were to blame for the experience.

Some patients reported complex personal contexts affecting the visit and difficulty resolving the experiences. The study found restraint use can aggravate some mental health conditions, such as PTSD and anxiety. One respondent said, "The experience in the emergency room, it's traumatic as hell," as cited by STAT

"Rapid control of an out-of-control situation is the default in ER settings," Matthew Wynia, MD, a physician and bioethicist at Aurora-based University of Colorado Anschutz Medical Campus, told STAT. He co-authored an editorial that accompanied the study. He added, "[Clinicians] may not recognize how incredibly damaging an experience of restraint can be." 

Some patients said their experiences led them to lose trust in the healthcare system or avoid it entirely.

Experts recommend creating a space in ERs where staff can de-escalate situations without restraints, while Dr. Wynia suggested having someone sit with a restrained patient to minimize feelings of isolation and abandonment.  

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