ArticleJournal of the American College of Emergency Physicians open2023
Physical restraint use in children with mental and behavioral health emergencies in the prehospital setting.
Article in Journal of the American College of Emergency Physicians open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed, 2 citations in OpenAlex.
- 'In the Midst of a Thunderstorm': Young People's Experiences of Physical Restraint in Inpatient Mental Health Services in the UK.International journal of mental health nursing · 2026Article
- Restraint care in the pediatric intensive care unit: a qualitative investigation of nurses' perspectives and experiences.Frontiers in pediatrics · 2026Article
- Prehospital Restraint Use in Pediatric Patients With Mental and Behavioral Health Emergencies.Pediatric emergency care · 2025Article
- Characteristics of pediatric behavioral health emergencies in the prehospital setting.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024Article
- Physical restraint use in children with mental and behavioral health emergencies in the prehospital setting.Journal of the American College of Emergency Physicians open · 2023Article
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: Emergency medical services (EMS) transport for mental and behavioral health (MBH) emergencies occurs frequently in children, yet little is understood regarding prehospital physical restraint use despite the potential for serious adverse events. We aim to describe restraint use prevalence and primary impressions among children with MBH emergencies. Methods: This is a retrospective cross-sectional study of children with MBH emergencies evaluated by Alameda County (ALCO), California EMS from January 1, 2012 to December 31, 2018. Patient demographics and clinical variables were collected from the EMS records including sex, age at time of encounter, year of encounter, transport destination, medication use, and primary impression(s). The primary outcome was the use of physical restraints. Descriptive statistics were used to characterize the primary outcome and associated demographic and diagnostic features, as well as temporal use patterns. Sex and age were compared between restrained and non-restrained youth using chi-square analysis. Results: Over the 7-year study period, ALCO EMS transported 9775 children with MBH emergencies. Of these transports, 1205 (12.3%) were physically restrained. Most children restrained had the primary impression of "behavioral/psychiatric crisis" (51.1%), "psychiatric crisis" (27.4%), and "behavioral-other" (12.4%) and the remaining children (9.1%) had a non-psychiatric/behavioral health primary impression. Over time, there was no statistically significant change in either number of children with MBH emergencies transported or physical restraint rate. Conclusions: More than 1 in 8 children with MBH emergencies are being physically restrained during EMS transport. Restraint rate did not substantially change over time. Further studies to understand existing restraint rates and EMS resources available to address acute agitation in children are needed to inform quality and care enhancing initiatives.
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Registered trials
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