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The shoulder: taking the strain during restraint
Author(s) -
HOLLINS L. P.,
STUBBS B.
Publication year - 2011
Publication title -
journal of psychiatric and mental health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 63
eISSN - 1365-2850
pISSN - 1351-0126
DOI - 10.1111/j.1365-2850.2010.01670.x
Subject(s) - framing (construction) , variety (cybernetics) , medicine , psychological intervention , intervention (counseling) , physical therapy , physical medicine and rehabilitation , psychology , applied psychology , nursing , computer science , engineering , structural engineering , artificial intelligence
Accessible summary• Every time nursing staff use physical intervention techniques there is a risk of injury. • Many commonly used techniques involve controlling the arm, and in so doing place the shoulder under stress. • This article examines how the shoulder can be injured during restraints, and offers safety guidelines for consideration.Abstract The decision to use or utilize physical intervention techniques is a contentious one. There has been much discussion on the complex legal and ethical dimensions framing the use of force. The risk of injury has also been considered in detail, but almost all of the published work has focused on restraint asphyxia, the prone restraint hold and the use of particular pain compliance techniques such as the wrist flexion hold. This paper focuses on the structure and function of the shoulder and examines how physical interventions and a variety of risk factors can threaten its physical integrity. This paper is for practitioners such as training commissioners, trainers, frontline staff and investigators or regulators who have to make considered determinations on the potential immediate physical impact of a variety of holds and escape manoeuvres. Sound risk assessment must be premised on a sound understanding of anatomy and physiology.