An Investigation into the Physiological and Psychological Impact of Supine and Side Lying Physical Restraint Techniques

Barnett

Abstract

This research investigated the physiological and psychological impact of supine and side lying physical restraint (PR) positions which have been suggested as safer alternatives to prone restraint positions. Twenty adults participated. From baseline Forced Vital Capacity (FVC) reduced by 10.4%, 10.4% and 14.6%, and FEV1 reduced by 7%, 7%, and 12% for supine arms low (SPR-AL), supine arms high (SPR-AH), and Side Lying restraint (SLR) respectively. SLR imposed the greatest Thoracic Weight bearing Pressure (TWP) at 116.1 (±17.5) mmHg, which was ~17% more than SPR-AH, and ~23% more than SPR-AL. HR was unaffected. Comfort was perceived to be greatest for SPR-AL, with SPR-AH being 6.7% less comfortable and SLR being 45% less comfortable. Anxiety was greatest in SLR, with SPR-HL and SPR-AL being 36.5% and 48.1% less anxiety inducing respectively. Breathing limitation was greatest in SLR, with SPR-AH and SPR-AL being 44.4% and 46.3% less limiting respectively. Compared to baseline all three restraint positions reduced respiratory measures (p = 0.001), with SPR-AL and SPR-AH being similar but differing from SLR (p = 0.001), and resulted in perceptions of discomfort, anxiety, and breathing limitation, with SLR being the most negatively impactful position tested. These findings are in keeping with our previous research which showed variance in the physiological and psychological impact of different restraint positions. All restraint positions possess the ability to negatively impact an individual both physiologically and psychologically but that impact is not homogenous, with some positions clearly possessing a lower level of risk than others.

Citation

Barnett. (2019). An Investigation into the Physiological and Psychological Impact of Supine and Side Lying Physical Restraint Techniques

• Acceptance Date: Aug 1, 2019
• Publication Date: Sep 2, 2019
• Journal: Journal of Emergency Medicine and Care
• Print ISSN: 2639-9253
• Keywords: Physical Restraint; Supine; Side Lying; Physiology; Psychology
• Publisher URL: http://www.annexpublishers.com/journals/journal-of-emergency-medicine-and-care/articles-in-press.php