Physical Control in Care Training Manual - Independent Advisory ...

PHYSICAL CONTROL IN CAREcomply with your instructions. Failure to respond to instructionsshould not be mistaken for deliberate non-compliance. It is valuableto listen to the person and attempt to understand why they arebehaving as they are.Even though what the person says may appear strange, it is oftenpossible to understand, predict what they will do next and interactwith them.Using restraint on young people experiencing psychosisThere may be an increased level of risk in using any restrainttechniques to control a psychotic young person without the benefit ofmedical support. As a result of fear or confusion the young person’sresponses may be abnormal, resulting in them struggling violentlyagainst persistent attempts to bring them under control throughrestraint. Prolonged restraint, which is violently resisted by a confusedand frightened individual, may result in harm or death due toexhaustion.Mental health services frequently use manual restraint with psychoticpatients. Restraint may be necessary to prevent harm to themselvesor others. Medical support is essential. In addition to providingphysical health care, a doctor may consider disturbed behaviourcaused by illness to be suitable for treatment by sedation, reducingthe need for restraint. The length of time the person is restrained is akey issue: medical literature suggests prolonged restraint is thebiggest risk factor and this is supported by the National HealthService and National Institute for Health and Clinical Excellence(‘NICE’) guidance. 9Excited DeliriumDescriptionExcited delirium 10 is both a mental state and a physiological arousal.It is closely associated with three underlying medical conditions:9 National Institute for Health and Clinical Excellence (2005) Violence: The Short-Termmanagement of Disturbed/Violent Behaviour in Psychiatric In-patient and EmergencyDepartments Guideline. London: NICE10 Di Maio TG, and Di Maio VJM (2006) Excited Delirium Syndrome: Cause of Death andPrevention Taylor and Francis, New York.© National Offender Management Service National Tactical Response GroupJuly 201036