ArticleDeutsches Arzteblatt international2012
Deaths due to physical restraint.
Article in Deutsches Arzteblatt international, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 4 of them syntheses that pooled it.
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Who cites it
34 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Is mental health staff training in de-escalation techniques effective in reducing violent incidents in forensic psychiatric settings? - A systematic review of the literature.BMC psychiatry · 2023Pooled it
- The Effectiveness of Educational Training or Multicomponent Programs to Prevent the Use of Physical Restraints in Nursing Home Settings: A Systematic Review and Meta-Analysis of Experimental Studies.International journal of environmental research and public health · 2020Pooled it
- Physical Harm and Death in the Context of Coercive Measures in Psychiatric Patients: A Systematic Review.Frontiers in psychiatry · 2019Pooled it
- Development methods of guidelines and documents with recommendations on physical restraint reduction in nursing homes: a systematic review.BMC geriatrics · 2015Pooled it
- Implementation of a Multicomponent intervention to Prevent Physical Restraints In Nursing home residenTs (IMPRINT): study protocol for a cluster-randomised controlled trial.BMC geriatrics · 2015Trial
- Restraint in somatic healthcare: how should it be regulated?Journal of medical ethics · 2026Article
- Management of Agitation in Emergency Medical Services for Older Adults: A Qualitative Exploration.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Investigating the association of mechanical restraint with somatic harmful outcomes: national register-based study.BJPsych open · 2024Article
- Least restraint principle in hospital care.Canadian family physician Medecin de famille canadien · 2024Article
- Factors affecting nursing practice of patient physical restraint among nurses.Archives of public health = Archives belges de sante publique · 2024Article
- Physical Restraint Use in Nursing Homes-Regional Variances and Ethical Considerations: A Scoping Review of Empirical Studies.Healthcare (Basel, Switzerland) · 2023Review
- Safeguarding patients while implementing mechanical restraints: A qualitative study of nurses and ward staff's perceptions and assessment.Journal of clinical nursing · 2023Article
- Coercion in intensive care, an insufficiently explored issue-a scoping review of qualitative narratives of patient's experiences.Journal of the Intensive Care Society · 2023Article
- Prevalence and Risk Factors of Neuropsychiatric Symptoms in Institutionalized Patients with Parkinson's Disease in Taiwan: A Nationwide Observational Study.Healthcare (Basel, Switzerland) · 2023Article
- Entrapment within an ottoman storage bed: an unusual accidental asphyxial death.Forensic science, medicine, and pathology · 2022Article
- [Dealing with coercion in intensive care medicine : Recommendations from the Ethics Section of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) in collaboration with the Ethics Section of the German Society for Internal Intensive Care and Emergency Medicine (DGIIN)].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2022Review
- Acute or chronic pulmonary emphysema? Or both?-A contribution to the diagnosis of death due to violent asphyxiation in cases with pre-existing chronic emphysema.International journal of legal medicine · 2022Article
- Effects and implementation of a minimized physical restraint program for older adults in nursing homes: A pilot study.Frontiers in public health · 2022Article
- A New Perspective on Human Rights in the Use of Physical Restraint on Psychiatric Patients-Based on Merleau-Ponty's Phenomenology of the Body.International journal of environmental research and public health · 2021Review
- The principles of physical restraint use for hospitalized elderly people: an integrated literature review.Systematic reviews · 2021Review
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPhysical restraint is used primarily for patients at risk of falling, those with motor unrest and agitated behavior, and those who manifest an intention of doing harm to themselves or are at risk of suicide. The use of freedom-restraining measures (FRM), and, in particular, the use of physical restraints against the patient's will, can be a serious intrusion of basic human rights and, as such, an act of violence against the patient. The improper use of physical restraints can cause injuries of varying severity, which can sometimes be fatal.
methodsWe analyzed all cases of death under physical restraint that were recorded in the autopsy reports of the Institute of Forensic Medicine in Munich from 1997 to 2010.
resultsAmong the 27 353 autopsies conducted over the period of the study, there were 26 cases of death while the individual was physically restrained. Three of these cases involved patients who died of natural causes while restrained, and one was a suicide. The remaining 22 deaths were caused solely by physical restraint; all of them occurred in patients under nursing care who were not continuously observed. The immediate cause of death was strangulation (11 cases), chest compression (8 cases), or dangling in the head-down position (3 cases). In 19 of these 22 patients, the restraints were incorrectly fastened, including two cases in which improvised non-standard restraints were used. One nursing-home patient died because of an abdominal restraint even though it had been correctly applied: She was mobile enough to slip through the restraint till it compressed her neck, and then unable to extricate herself from it, so that she died of strangulation.
conclusionTo prevent such deaths, we recommend from a forensic medical standpoint that all possible alternatives to FRM should be used instead. If direct-contact restraints are truly necessary, they must be applied as recommended and the restrained person must be closely observed.
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