Part 2. Chemical and physical restraints in the management of mechanically ventilated patients in the ICU: a patient perspective

Intensive Crit Care Nurs. 2007 Dec;23(6):316-22. doi: 10.1016/j.iccn.2007.04.002. Epub 2007 May 23.

Abstract

An important goal of the care for the mechanically ventilated patient is to minimize patient discomfort and anxiety. This is partly achieved by frequent use of chemical and physical restraints. The majority of patients in intensive care will receive some form of sedation. The goal and use of sedation has changed considerably over the past few decades with literature evidencing trends toward overall lighter sedation levels and daily interruption of sedation. Conversely, the use of physical restraint for the ventilated patient in ICU differs considerably between nations and continents. A large portion of the literature on the use of physical restraint is from general hospital wards and residential homes, and not from the ICU environment. Recent literature suggests minimal use of physical restraint in the ICU, and that reduction programmes have been initiated. However, very few papers illuminate the patient's experience of physical and chemical restraints as a treatment strategy. In Part 1 of this two-part review, the evidence on chemical and physical restraints was explored with specific focus on definitions of terms, unplanned extubation, agitation, delirium as well as the impact of nurse-patient ratios in the ICU on these issues. This paper, Part 2, examines the evidence related to chemical and physical restraints from the mechanically ventilated patient's perspective.

Publication types

  • Review

MeSH terms

  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Hypnotics and Sedatives / adverse effects
  • Hypnotics and Sedatives / therapeutic use*
  • Intensive Care Units
  • Quality of Health Care
  • Respiration, Artificial*
  • Restraint, Physical* / adverse effects
  • Restraint, Physical* / psychology
  • Safety Management

Substances

  • Hypnotics and Sedatives