RESTRAINING INFANTS AND CHILDREN And Nursing Responsibilities

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Principles

Nursing Responsibilities

1. Various restraints, to facilitate examination or maintain safety, are essential in the care and treatment of pediatric patients. Whenever possible, explain the reason for the restraint to the parents and the child.
2. Restraints are used only when necessary. The use of restraints is essential when the infant or child is in a high chair or wheelchair.
3. Improperly applied restraints can cause skin irritation and can impair circulation. Any kind of restraint must be checked every 15 minutes and removed periodically. Good body alignment should be maintained.

Adequate padding under wrist and ankle restraints is essential to prevent skin irritation.

4. Free movement facilitates growth and development. When prolonged restraint is necessary, restrain the fewest number of joints possible.

 

Clove-hitch restraint

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The clove-hitch restraint is used to restrain one limb or all four. It is made from a long gauze or commercial ties. Make two loops with the gauze and bring them together as shown in the picture. Adjust the loops snugly to the wrist or ankle and tie the ends to the mattress spring. The restraint should not tighten when both ends are pulled taught. Padding the skin is essential.

 

Mummy restraint

The mummy restraint may be used during many procedures such as gastric washing; eye, ear, or throat examinations.

How to make a mummy restraint?

1. Place a blanket or draw sheet flat on the bed.

2. Place the infant on his back on the sheet with the top of the sheet at the infant’s shoulder line and the bottom of the sheet extending approximately 10 to 12 inches beyond his feet.

3. Place the infant’s arm at his side in anatomical position.

4. Fold the sheet over the body and under the arm at the opposite side, tucking the excess securely under the infant.

5. Place the other arm in anatomical position.

6. Fold the sheet over the body and tuck the excess under the infant.

7. Separate the corners of the bottom portion of the sheet to give it width and fold it up toward the shoulder. Tuck both sides of the sheet under the infant’s body and secure by crossing one side over the other in the back and tucking in the excess.

 

Mummy Restraint – Steps

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The Safety Crib Cover

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The crib cover is made of clear, break-resistant plastic. It permits the child freedom of movement within the crib while ensuring he cannot climb or fall out of the crib.

 

The Elbow Restraint

The elbow restraint is a piece of material into which tongue depressors have been inserted at various intervals .Place the elbow in the center of the restraint and wrap the restraint around the infant’s arm. The restraint may be anchored by means of string or safety pins.

The tongue depressors prevent flexion of the elbow but otherwise do not limit freedom of movement. The elbow restraint may be used for infants who are receiving scalp-vein infusions, those who have eczema of the face or body, and infant’s who have had cleft-lip repairs. The restraint must be removed frequently to prevent brachial nerve damage.

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