UMEM Educational Pearls

This study was a retrospective review of restraint use at a level 1 trauma center in the Midwest.

It found the following were factors in a patient encounter associated with an increased risk of restraint usage:

  • drug or alcohol intoxication (highest OR)
  • American Indian race
  • male gender
  • Medicaid or self pay insurance
  • dx of bipolar disorder, psychosis

This study found a decreased OR of restraint use with Black or Hispanic race, which was in contrast to other studies

This was a single center, retrospective study, so it was already limited in what it could tell us.  In addition, they didn't see  the reason for the restraints being ordered in the first place. Nonetheless, it does show that people in certain marginalized groups have a higher likelihood of ending up in restraints.  Please think twice when ordering restraints in the ED, especially for behavioral reasons


Factors Associated With Physical Restraint in an Urban Emergency Department

Aaron E. Robinson, MD, MPH

Brian E. Driver, MD

Jon B. Cole, MD

Aida W. Strom

Erik R. Brodt, MD

Thomas E. Wyatt, MD

Published:September 19, 2023DOI: