Weiss EM, et al. Deadly restraint: a Hartford Courant investigative report.
Hartford Courant 1998; October 11 15.
October 11, 1998
This series DEADLY RESTRAINT is available on The Courant's Web site, including a national database of restraint-related deaths, a discussion forum and more. www.courant.com. [No longer offered without charge.]
* Commonly used terms and their definitions.
PHYSICAL RESTRAINT: A broad category of restraints in which a patient's movements are restricted by the use of physical force. This action is usually taken to prevent an upset or agitated person from hurting himself or others. MECHANICAL RESTRAINT: A broad category of restraints in which a patient is immobilized through external devices such as straps, belts, wrist or ankle cuffs, or restrictive clothing such as straitjackets.
SECLUSION: When a patient is separated from the general population of a facility and not permitted to return at will. Typically, the person is placed in a designated room, which is often padded. The room is often locked but typically has observation windows or cameras so staff may watch.
TWO-POINT RESTRAINTS: A standard mechanical restraint method. A device wraps around the waist and has straps or cuffs that go around the wrists to immobilize the arms.
FOUR-POINT RESTRAINTS: Another standard mechanical restraint method. The patient is placed on his back, typcally on a bed. The wrists and ankles are strapped to the bed to immobilize the patient.
FIVE-POINT RESTRAINT: Same as above, with the addition of a strap or cloth device to restrict the patient's midsection.
TAKEDOWN: A broad term referring to a worker forcing the patient to the ground.
BASKET HOLD: A commonly used, but often misused, term. Leading experts describe a basket hold as a physical restraint in which a worker holds a patient from behind. The worker grasps the patient's wrists, and crosses the patient's arms across his or her chest. The worker then brings the patient to a seated position by stepping back and riding the patient down along the worker's thigh.
BODY NET: A vinyl net that is used to wrap a patient securely. The net has openings through which the arms are pulled and then strapped to the patient's side.
BODY BAG: A large piece of reinforced cloth or canvas that is wrapped around the body and secured with zippers or straps.
STRAITJACKET: A coat-like device that is worn by a patient and used to bind his arms tightly against his body. Also known as a camisole.
FLOOR HOLD: A broad term encompassing a number of physical restraints during which a patient is forced to lie on the floor.
FACE-DOWN RESTRAINT: A broad term referring to a physical restraint during which the patient is facing the ground and staff members are either atop or beside the patient.
VEST POSY: A vest that some facilities use during a bed or chair restraint.
PELVIC POSY: A cloth device that some facilities use during a bed restraint. The vest goes across the pelvis and keeps a person from wriggling out of arm and leg restraints.
CARDIAC CHAIR: A padded recliner into which a patient is strapped. Often used in nursing homes. Also known as geri-chair or restraint chair.
THORAZINE: a tranquilizer used in psychiatric hospitals to calm unruly patients. In some cases found by The Courant, Thorazine was administered during a restraint.
Hartford Courant DEADLY RESTRAINT Investigation DATA BASE
DAY ONE; October 11: A Nationwide Pattern of Death
DAY TWO; October 12: Little Training, Few Standards, Poor Staffing Put Lives At Risk
DAY THREE; October 13: Patients Suffer In A System Without Oversight
DAY FOUR; October 14: People Die And Nothing Is Done
DAY FIVE; October 15: From "Enforcer" To Counselor
Hartford Courant October 17th-published Related Article:
REFORM URGED IN USE OF RESTRAINTS
U.S. LAWMAKERS RESPOND TO REPORT ON DEATHS
Hartford Courant October 24th-published Related Article:
GROUPS CALL FOR REFORM IN USE OF RESTRAINTS
MENTAL HEALTH PROVIDERS REACT TO REPORTS OF 142 DEATHS IN FACILITIES
Hartford Courant DECEMBER 16th-published Related Article:
USE OF IMPROPER RESTRAINTS WIDESPREAD, GROUPS SAY
How the Courant Conducted Its Investigation