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Metas de Enfermería

Metas de Enfermería

DICIEMBRE 2018 N° 10 Volumen 21

Mechanical restraint for critical patients with orotracheal intubation

Section: Revisiones

How to quote

De la Fuente de la Fuente N. La contención mecánica en el paciente crítico con intubación orotraqueal. Metas Enferm dic 2018/ene 2019; 21(10):66-76.

Authors

Nerea de la Fuente de la Fuente

Position

Enfermera. Hospital Universitario Donostia. San Sebastián (Gipuzkoa)

Contact address

Nerea de la Fuente de la Fuente. C/ Olibet, 4. 20100 Errenteria (Gipuzkoa).

Contact email: neredlf@gmail.com

Abstract

Objective: to review the evidence available about the use of mechanical restraint (MR) at Critical Care Units.
Method: a narrative review of studies published, without time limitation, until April 2017 in the following databases: Cuiden, Pubmed, Proquest, Trip Data Base and OvidMD, using the terms: “CriticalCare” (“Cuidados Críticos”), “Restraint, Physical” (“Contención, Física”), “Airway Extubation” (“Extubación, Vías respiratorias”). There was a selection of articles in English and in Spanish; protocols regarding mechanical restraint were also added.
Results: there was a selection of 35 articles and 11 protocols. The documentary review generated the following categories of analysis: mechanical restraint and unscheduled extubation, involvement of nurses in the use and maintenance of mechanical restraint, different strategies to prevent the use of MR, factors to be considered, and guidelines about the use of mechanical restraint in critical patients.
Conclusions: the main objective of mechanical restraint is to prevent self-extubation, but there are no studies supporting its efficacy. Nurses will usually make the initial decision to apply restraint, and this action won’t always entail an informed consent and entry in the clinical record. International organizations advocate the minimization of restraint, and recommend using it as the last option after using up all alternative options. It is necessary to conduct more studies about the alternative options to restraint.

Keywords:

Critical care; physical restraint; immobilization; tracheal extubation; Nursingmechanical containment

Versión en Español

Título:

La contención mecánica en el paciente crítico con intubación orotraqueal