Excessive Restraints

[TheWho]

You guys have been busy, seems I have some reading and catching up to do.

Here are some definitions that I found:

Physical restraint: A broad category of restraints in which a patient's movements are restricted by the use of physical force. This action is usually taken to prevent upset or agitated persons from hurting themselves or others

Mechanical restraint: A broad category of restraints in which a patient is immobilized through external devices such as straps, belts, wrist and ankle cuffs, or restrictive clothing such as straitjackets.

Body net: A vinyl net that is used to wrap a patient securely. The net has openings through which the arms are pulled and then strapped to the patient's side.

The body net seems to be designed to keep the patient cooler (for use in warmer climates maybe)



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[Anonymous]

http://www.teenliberty.org/Voices.htm

1. How to Drive a Kid Crazy.

Writes one 14-year-old about his stay in a mental rehab facility:

"If you do what they want, you are manipulating. If you don't, then you are defiant. If you walk around the ward, then you are pacing, if you sit down, then you are withdrawn. If you say you're sick, then you're trying to get attention. If you say you're not sick, then you are in denial. If you do your schoolwork right then you are a perfectionist who is obsessive about details. If you make mistakes, then you are sloppy and obviously don't care about education. And you know what? My doctor says this hospital is good for me because it's consistent."

2. Standing Torture

"I had to stand facing a wall for three days, except for going to the bathroom, because I had dust on my chair. My muscles killed me for three weeks. But if you fall down, you'll be shot up with Thorazine or put in seclusion for being defiant. So you stand there, and you have nothing to do but think. I'd pretend I was riding through LA on a bus, and reciting streets in my head, or play chess in my head, or count backwards from 2,000 by sevens. Otherwise you'd go berserk.

Everyone got punished for one person's offenses. [Once] we had to scrub the gym floor with a toothbrush 12-hours a day for three weeks because one girl wanted to run away."

Lyn Duff, whose account was published in Sassy magazine (June 1994), was committed by her parents to a private, for-profit mental hospital. She was sent there after her mother read her diary and found a love poem to another girl.

3. Torture in Restraints

" was put in restraints a lot during my first few weeks at the hospital," writes another teen.

"Every time a staff person told me to do something," he says, "I wouldn't do it. I was so mad about being there that I just said 'no way' to every order. When you don't do as they say, then you get a time out. And then you get put in SR (Seclusion Room) in restraints. It depends on what insurance you got and what the regulations are.

"Restraints are like a belt that goes around your waist and then there are these leather and plastic loops and they attach the handcuffs to the belt. So your arms are behind your back the whole time and you get sore!

"That's during the day. At night it's worse. They put you in five point, which is the loop and leather belt around your hands to attach them to the bed. And the same with your legs and they are spread apart. Then there is a leather belt from around the waist too.

"You stay in restraints for five days, but only in five point at nights unless you try to run or something. If you get them on a Tuesday and you are supposed to get [them] off on Saturday, it doesn't matter because the doctor isn't in and you have to wait for Monday when they come back to work. Unless, of course, Monday could be a holiday."

[Anonymous]

"deadly restraint"

articles and defintions

http://www.charlydmiller.com/LIB05/1998 ... terms.html

* Commonly used terms and their definitions.

PHYSICAL RESTRAINT: A broad category of restraints in which a patient's movements are restricted by the use of physical force. This action is usually taken to prevent an upset or agitated person from hurting himself or others. MECHANICAL RESTRAINT: A broad category of restraints in which a patient is immobilized through external devices such as straps, belts, wrist or ankle cuffs, or restrictive clothing such as straitjackets.

SECLUSION: When a patient is separated from the general population of a facility and not permitted to return at will. Typically, the person is placed in a designated room, which is often padded. The room is often locked but typically has observation windows or cameras so staff may watch.

TWO-POINT RESTRAINTS: A standard mechanical restraint method. A device wraps around the waist and has straps or cuffs that go around the wrists to immobilize the arms.

FOUR-POINT RESTRAINTS: Another standard mechanical restraint method. The patient is placed on his back, typcally on a bed. The wrists and ankles are strapped to the bed to immobilize the patient.

FIVE-POINT RESTRAINT: Same as above, with the addition of a strap or cloth device to restrict the patient's midsection.

TAKEDOWN: A broad term referring to a worker forcing the patient to the ground.

BASKET HOLD: A commonly used, but often misused, term. Leading experts describe a basket hold as a physical restraint in which a worker holds a patient from behind. The worker grasps the patient's wrists, and crosses the patient's arms across his or her chest. The worker then brings the patient to a seated position by stepping back and riding the patient down along the worker's thigh.

BODY NET: A vinyl net that is used to wrap a patient securely. The net has openings through which the arms are pulled and then strapped to the patient's side.

BODY BAG: A large piece of reinforced cloth or canvas that is wrapped around the body and secured with zippers or straps.

STRAITJACKET: A coat-like device that is worn by a patient and used to bind his arms tightly against his body. Also known as a camisole.

FLOOR HOLD: A broad term encompassing a number of physical restraints during which a patient is forced to lie on the floor.

FACE-DOWN RESTRAINT: A broad term referring to a physical restraint during which the patient is facing the ground and staff members are either atop or beside the patient.

VEST POSY: A vest that some facilities use during a bed or chair restraint.

PELVIC POSY: A cloth device that some facilities use during a bed restraint. The vest goes across the pelvis and keeps a person from wriggling out of arm and leg restraints.

CARDIAC CHAIR: A padded recliner into which a patient is strapped. Often used in nursing homes. Also known as geri-chair or restraint chair.

THORAZINE: a tranquilizer used in psychiatric hospitals to calm unruly patients. In some cases found by The Courant, Thorazine was administered during a restraint.

[Anonymous]

Position paper from the canadian mental health -

Seclusion And Restraint

Seclusion and restraint procedures not only represent a significant infringement of an individual's right to autonomy and self-determination but also are associated with significant morbidity and mortality. Whereas the risks of seclusion and restraint have been well established, the benefits remain uncertain.

The following report describes a snapshot review conducted by the Psychiatric Patient Advocate Office (PPAO) in 2000 of seclusion and restraint practices within Ontario Provincial Psychiatric Hospitals and the former Queen Street Mental Health Centre. The PPAO undertook this review in response to the high frequency of concerns and issues raised by patients served related to the use of seclusion and restraint.

http://www.ppao.gov.on.ca/pos-sec.html

[ZenAgent]

Now the tread is beginning to be about relationship between who and CCM. That is exactly as interesting as reading about Amber and Peter, when they were fooled into Foreland Hamlet.

Could we discuss reality instead?

How can we get into the parent group on google? They must have a idea about what a body net is?

I know that the parents here on this forum did not place their kid in PV, but what did they think the body net and the jacket meant? They use so nice words, but do they fool anyone?

Zen: What did you think that they meant with the jacket and net before you actually saw it?

Settle: Did you ever discuss these items with your parents? Did they know what they actually consented to?

We didn't get a copy of the handbook when our girl was placed in PV, we had to ask for it.  By then, we had already learned the place was hell, the handbook only made it worse.  We had already read about the "burrito", the straitjacket.  It's a straitjacket to me, maybe that's not acceptable anymore.

[TheWho]

I dont think there is a question in anyones mind whether or not restraints are needed and the AMA, AACAP and ISPN all see the value in their use.  The problem is using the restraints properly and having trained staff....

The guidelines for schools regarding the use of physical restraint on children are the result of decades of professional practice, state and federal legislation, case law, and grassroots efforts by advocacy groups, all concerned with the safety of children. To ensure that empirically based best practices are developed and become common practice among schools, it is incumbent upon various professional and advocacy organizations to monitor and hold school districts (as well as other agencies) across the nation accountable………..
……..Due to the current risk of student injuries and the mortality rates associated with the use of physical restraint, immediate action is required to ensure that schools employing restraint do not jeopardize student safety. Based on the review of case law, legislation, and recommended procedures from both professional organizations and advocacy groups, there is a need for clear standards regarding the use of restraint procedures in schools, as well as mandatory training of staff before they use restraint. Improved and standardized record keeping and notification of administrators and parents of incidents in which restraint occurs are also important. Additional research is needed to define situations in which restraint is appropriate in schools, as well as its effectiveness in containing or preventing violent or destructive behavior. Unless these recommendations are heeded and action is taken, headlines will continue to appear across our nation describing these preventable fatalities.
Advocacy groups involved:
AMA

(AACAP), the American Academy of Pediatrics, and the American Psychiatric Association

International Society of Psychiatric and Mental Health Nurses (ISPN)



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[SettleForNothingLess]

Now the tread is beginning to be about relationship between who and CCM. That is exactly as interesting as reading about Amber and Peter, when they were fooled into Foreland Hamlet.

Could we discuss reality instead?

How can we get into the parent group on google? They must have a idea about what a body net is?

I know that the parents here on this forum did not place their kid in PV, but what did they think the body net and the jacket meant? They use so nice words, but do they fool anyone?

Zen: What did you think that they meant with the jacket and net before you actually saw it?

Settle: Did you ever discuss these items with your parents? Did they know what they actually consented to?

We didn't get a copy of the handbook when our girl was placed in PV, we had to ask for it.  By then, we had already learned the place was hell, the handbook only made it worse.  We had already read about the "burrito", the straitjacket.  It's a straitjacket to me, maybe that's not acceptable anymore.

And my response to the question asked is unfortunatly my dad wont talk to me about it.

[SettleForNothingLess]

Here is an example of one of my restraints:
Mechanical restraint started at 1:55 PM. Mechanical restraint DCed at 9:55 PM. thats 7 hours of being tied down. 5 Mgs of Haldol, 50 Mgs of Benadryl, and 15 Mgs of Zyprexa Zydis administered at 5:10 PM.
Restrain using body net.

Zyprexa
Indications & Dosage

Efficacy in schizophrenia was demonstrated in a dose range of 10 to 15 mg/day in clinical trials. However, doses above 10 mg/day were not demonstrated to be more efficacious than the 10 mg/day dose. An increase to a dose greater than the target dose of 10 mg/day (i.e., to a dose of 15 mg/day or greater) is recommended only after clinical assessment. The safety of doses above 20 mg/day has not been evaluated in clinical trials

Children require smaller dosages of haloperidol than do adults. The recommended initial dosage of haloperidol for controlling psychotic symptoms in children is 0.5–2.0 mg two or three times each day. The recommended dosage for controlling symptoms of Tourette's syndrome and other non-psychotic disorders is between 0.075 and 0.05 mg per kilogram of body weight per day. The total dosage is usually divided into two or three administrations per day. The goal of therapy is to use the smallest amount of haloperidol that will control symptoms. Children under age three should not take this drug.

Is PV trying to cover-up their ignorance of therapy with an abundance of pharmacy?  That's sickening, and it seems incredibly ignorant to administer all that to you at once, and criminal to give you those dosages.

Zen, we really cannot say, by just looking at a log, if the amounts were appropriate or not.

Zeprexa is manufactured in tablet doses of:

2.5, 5, 7.5, 10, 15, 20 mg.

Treatment of bipolar disorder usually is initiated with oral doses of 10-15 mg once daily. The dose may be increased by 5 mg daily at 24 hour intervals. Doses greater than 20 mg daily have not been evaluated. In clinical trials, doses of 5-20 mg daily were effective.


You need to be careful how you distinguish between treatment and chemical restraint.  If a person is being administered a drug as part of their treatment then it is not considered a restraint.  If a drug is being administered to control a person’s behavior then it could be considered dosing for restraint.  So it is the process of prescribing rather than the agent prescribed that distinguishes treatment from restraint.



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It was not the argument about Zyprexa... it was why administer HALDOL, BENADRYL, and ZYPREXA   all at the same time??? whats the point of a cocktail like that?

[SettleForNothingLess]

Here is an example of one of my restraints:
Mechanical restraint started at 1:55 PM. Mechanical restraint DCed at 9:55 PM. thats 7 hours of being tied down. 5 Mgs of Haldol, 50 Mgs of Benadryl, and 15 Mgs of Zyprexa Zydis administered at 5:10 PM.
Restrain using body net.

Zyprexa
Indications & Dosage

Efficacy in schizophrenia was demonstrated in a dose range of 10 to 15 mg/day in clinical trials. However, doses above 10 mg/day were not demonstrated to be more efficacious than the 10 mg/day dose. An increase to a dose greater than the target dose of 10 mg/day (i.e., to a dose of 15 mg/day or greater) is recommended only after clinical assessment. The safety of doses above 20 mg/day has not been evaluated in clinical trials

Children require smaller dosages of haloperidol than do adults. The recommended initial dosage of haloperidol for controlling psychotic symptoms in children is 0.5–2.0 mg two or three times each day. The recommended dosage for controlling symptoms of Tourette's syndrome and other non-psychotic disorders is between 0.075 and 0.05 mg per kilogram of body weight per day. The total dosage is usually divided into two or three administrations per day. The goal of therapy is to use the smallest amount of haloperidol that will control symptoms. Children under age three should not take this drug.

Is PV trying to cover-up their ignorance of therapy with an abundance of pharmacy?  That's sickening, and it seems incredibly ignorant to administer all that to you at once, and criminal to give you those dosages.

Zen, we really cannot say, by just looking at a log, if the amounts were appropriate or not.

Zeprexa is manufactured in tablet doses of:

2.5, 5, 7.5, 10, 15, 20 mg.

Treatment of bipolar disorder usually is initiated with oral doses of 10-15 mg once daily. The dose may be increased by 5 mg daily at 24 hour intervals. Doses greater than 20 mg daily have not been evaluated. In clinical trials, doses of 5-20 mg daily were effective.


You need to be careful how you distinguish between treatment and chemical restraint.  If a person is being administered a drug as part of their treatment then it is not considered a restraint.  If a drug is being administered to control a person’s behavior then it could be considered dosing for restraint.  So it is the process of prescribing rather than the agent prescribed that distinguishes treatment from restraint.



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It was not the argument about Zyprexa... it was why administer HALDOL, BENADRYL, and ZYPREXA   all at the same time??? whats the point of a cocktail like that?

And all of those were recieved while tied down to a bed, whats the point? and no they were not a part of my medication regiment....

[ZenAgent]

The body net seems to be designed to keep the patient cooler (for use in warmer climates maybe)
...

Like they give a shit about the kid's comfort...

[SettleForNothingLess]

The body net seems to be designed to keep the patient cooler (for use in warmer climates maybe)
...

Like they give a shit about the kid's comfort...

 :rofl:  :rofl:  :rofl:

[TheWho]

(Ding,Ding,Ding)
...

(Dong, Dong, Dong)

When are you changing your name to Air Supply, dude?  Why don't you be ABBA?

Abba ? I never heard of it…Air Supply, I have, but couldn’t name a song…I am more of a Floyd, Zepplin, ELP,Crimson, Rick Wakeman type.  Tell you what, I will consider changing my Name if you drop the “ Zenâ€

[SettleForNothingLess]

(Ding,Ding,Ding)
...

(Dong, Dong, Dong)

When are you changing your name to Air Supply, dude?  Why don't you be ABBA?

Abba ? I never heard of it…Air Supply, I have, but couldn’t name a song…I am more of a Floyd, Zepplin, ELP,Crimson, Rick Wakeman type.  Tell you what, I will consider changing my Name if you drop the “ Zenâ€

[Anonymous]

you both have really horrible "dad rock" taste in music

[TheWho]

(Ding,Ding,Ding)
...

(Dong, Dong, Dong)

When are you changing your name to Air Supply, dude?  Why don't you be ABBA?

Abba ? I never heard of it…Air Supply, I have, but couldn’t name a song…I am more of a Floyd, Zepplin, ELP,Crimson, Rick Wakeman type.  Tell you what, I will consider changing my Name if you drop the “ Zenâ€