Use of restraint to manage challenging behaviour in children after traumatic brain injury

Abstract

Traumatic brain injury is the most common cause of acquired disability in children. Behavioural problems that cause challenges to care such as aggression, confusion, agitation, refusal to cooperate, climbing out of bed, attempting to abscond from the ward, and removing invasive drains or intravenous lines are common after brain injuries. This can cause significant problems with maintaining the safety of the child and others, and can have significant negative effects on rehabilitation and recovery. This paper explores the literature around the use of restraint, defined as any intervention that restricts a child's voluntary movement or behaviour by any means, in such cases including physical, mechanical, technological, chemical and psychological. A paucity of relevant research and guidelines was found, putting children at risk of receiving poor care and nurses under professional, ethical and legal pressures.