Restraint of infants for treatment or procedures
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|Application||Type of Restraint||Watch points / monitoring|
|Physical||No||IV/LL/Peripheral IA||Limb immobilised: held by nursing/medical
staff during insertion.
Splint applied to limb across appropriate joint to ensure immobility and thus maintenance of therapy lines.
|Hourly site checks|
|Physical||No||UAC/UVC insertion||Restrained in folded nappies as per instructions below for duration of insertion.||Cardiac/SpO2
Frequent checks of infant.
|Physical||No||Lumbar puncture||Infant held on side with spine curved to
enable safe insertion of spinal needle.
Occasionally infants may be held sitting flexed forward.
|Protection of airway paramount
Appropriate respiratory support commenced before procedure commenced
Cardiac/SpO2 monitoring if appropriate
|Physical / chemical||No||Intubation||Infant held still with neck extended to facilitate
rapid safe intubation of airway.
Sedated/muscle relaxed with medication to aid correct insertion of ET tube easily.
|Physical||No||Chest drain insertion||Infant held on side with limbs immobilised
to facilitate insertion of trochar into pleural space.
Infant sedated and local anaesthetic used as appropriate.
|Physical||No||Transports||Infant transported in appropriate equipment
according to gestation and complexity of care
Transport incubator: infant restrained in harness to ensure safety while travelling via ambulance/aircraft.
Cot: infant restrained with harness within cot and appropriate restraint of cot in ambulance.
Car seat: infant restrained with appropriate harness and seat-belt to ensure safety during transport.
|Infant's comfort and safety
Appropriate monitoring for gestation and complexity
Restraint for Umbilical Artery or Venous Catheter Insertion
Restraint of Arms
- Using a cloth nappy fold top right hand corner diagonally into the middle, to form a triangle.
- Fold the opposite corner into the middle to meet the first fold.
- Fold the bottom edge up approximately 10 cm to form a pouch.
- Place infant on folded nappy.
- Place infant's hands by the side and into the pouch.
- Fold the right top corner down onto the chest.
- Fold the bottom right corner up over the chest and tuck under the infants right shoulder. Keep the umbilical area exposed.
- Repeat for the left side.
Restraint of Legs
- Using a cloth nappy fold top edge down approximately 10 cm. Slide folded edge under infant to waist level.
- Keeping legs in a comfortable position, wrap the legs to keep umbilical area exposed.
- Secure nappy by tucking excess under mattress at base of heat table.
- For large babies place a towel across the legs and tuck under each side of the mattress.
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- Date last published: 24 April 2007
- Document type: Clinical Guideline
- Services responsible: Neonatology
- Owner: Newborn Services Clinical Practice Committee
- Editor: Sarah Bellhouse
- Review frequency: 2 years
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