1. By Julie Stevenson RNMH/RNLD DIP.N

2.  This is only a demonstration and should not be used in the work  place without appropriate training,  Prevention is the best form of management  Physical restraint is only to be used when all other options have failed.  Call for assistance.  Restraint is not a punishment.  Use diversion techniques.  The law states we must use “reasonable” force.  During restraint ALWAYS check the condition of the patient,A.B.C.  In 1995 Zoe Fairly a 21 year old with a learning disability was restrained by 4 staff for over 30 minutes =died of positional asphyxia.  In1997Roger Sylvester age 30 was restrained by 8 staff=died of positional asphyxia.  In 1998 David Bennets heart stopped during restraint.  In 2000Michael Goldwaters heart stopped during restraint.  Between 1991 &2009 there were 22 deaths in the UK as a result of prolonged restraints.

3. Scenario 1  Someone shouting “I am going to kill you“  Demonstrate low level holds to seating & de- escalation.

4. Scenario 2  Aggressive patient attack…low level hold to figure of 4 hold to lowering to the floor hold forward position and turn over.

5. Scenario 3  Aggressive attack…low level hold to figure of 4 hold to lowering to the floor,backward position.

6. Scenario 4  Strangle hold against a wall…breakaway

7. Scenario 5  Strangle hold during struggle on the floor. breakaway.

8.  Effective communication is essential in the management of Violence & Aggression.  Behaviour is a way of communicating.  Always de-brief with patients &staff.  Document what happened Before, During and After the event noting times dates people involved, injuries sustained.

9.  Reflect……  Do not take the event personally.  Try to remain calm work in collaboration with the Multi –Disciplinary team.  Explore options, care plans and ways of dealing with stressful or aggressive situations.  Remember it is also stressful for the patient.  Any questions? THANK YOU