Physical restraint within the prehospital Emergency Medical Care Environment: A scoping review

IF 1.4 4区 医学 Q3 EMERGENCY MEDICINE African Journal of Emergency Medicine Pub Date : 2023-09-01 DOI:10.1016/j.afjem.2023.03.006
Jared MCDOWALL , Andrew William MAKKINK , Kelton JARMAN
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Abstract

Background

Psychomotor agitation and aggressive behaviour (AAB) have the potential to occur in any healthcare setting, including those in which Emergency Medical Services (EMS) operate. This scoping review aimed to examine the available literature on physical restraint of patients within the prehospital setting and to identify guidelines and their effectiveness, safety to patients and health care practitioners and strategies relating to physical restraint when used by EMS.

Methods

We performed our scoping review using the methodological framework described by Arksey and O'Malley augmented by that of Sucharew and Macaluso. Several steps guided the review process: identification of the research question, eligibility criteria, information sources (CINAHL, Medline, Cochrane and Scopus), search, selection and data collection, ethical approval, collation, summarizing and reporting on the results.

Results

The population of interest, in this scoping review was prehospital physically restrained patients, however, there was a reduced research focus on this population in comparison to the larger emergency department.

Conclusion

The limitation of informed consent from incapacitated patients may relate to the lack of prospective real-world research from previous and future studies. Future research should focus on patient management, adverse events, practitioner risk, policy, and education within the prehospital setting.

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院前急救医疗环境中的身体约束:范围界定综述
背景心理运动激动和攻击性行为(AAB)有可能发生在任何医疗环境中,包括紧急医疗服务(EMS)所在的环境。这项范围界定审查旨在审查关于院前环境中患者身体约束的现有文献,并确定指南及其有效性,EMS使用时对患者和医护人员的安全性以及与身体约束相关的策略。方法我们使用Arksey和O'Malley描述的方法框架进行了范围界定审查,并补充了Sucharew和Macaluso的方法框架。指导审查过程的几个步骤:确定研究问题、资格标准、信息来源(CINAHL、Medline、Cochrane和Scopus)、搜索、选择和数据收集、伦理批准、整理、总结和报告结果。结果在这项范围界定审查中,感兴趣的人群是院前身体受限的患者,然而,与较大的急诊科相比,对这一人群的研究重点有所减少。结论丧失行为能力患者知情同意的局限性可能与之前和未来研究缺乏前瞻性的现实世界研究有关。未来的研究应侧重于院前环境中的患者管理、不良事件、从业者风险、政策和教育。
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来源期刊
CiteScore
2.40
自引率
7.70%
发文量
78
审稿时长
85 days
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