Only to be used as a last resort if an agitated patient is at risk to themselves or others
It must be proportional to risk
Use half doses in elderly or renal impairment
Always offer oral route first
Oral therapy takes 45-60 minutes to take effect; IM therapy takes 30 minutes
Observations should be undertaken every 15-30 minutes
Ensure you very clearly document what you have done and why (including why it was really necessary, how you tired to de-escalate prior to restraint, how/why the restraint was proportional to risk, and that you offered oral medications prior to IM etc.)
Legal frameworks for restraint
Mental capacity act (for patients without capacity): allows restraint to protect self (not others)
Mental health act treatment sections (2/3; not 5): allow restraint to protect self and others
Common law: may be used for restraint to protect self/others in acute situations otherwise (but generally not recurrently)
Rapid tranquilisation protocol
Test your knowledge on legal frameworks
Mental Capacity Act
What is it?
How can you determine if a patient has capacity?
What does it allow you to do?
What documentation is required?
Mental Health Act
What is it?
List the commonly used Mental Health Act sections?