Registered Nurses' Association of Ontario

Possible Complications of Restraint Use

  • Nurses must have knowledge of the possible multiple medical, psychological and functional complications resulting from the use of restraints and be diligent in observation, monitoring and follow up.



Behaviour alterations

■ Increased agitation

■ Increased frustration

Cardiovascular system alterations

■ Change in blood pressure, volume and basal metabolic rate

■ Cardiac stress

■ Venous stasis (blood clot, pulmonary emboli), lower extremity edema


■ Asphyxia

■ Aspiration

■ Strangulation

Decreased functional status

■ Deconditioning

■ Increased dependency

Fecal impaction

Hydration and nutritional status alterations

■ Dehydration from lack of access to fluid

■ Loss of appetite

Incontinence of urine and stool


■ Nosocomial infections resulting from immobility (e.g. pneumonia)


■ Falls causing injury

Musculoskeletal alterations

■ Decrease muscle mass, tone and strength, stiffness

■ Contractures

■ Bone demineralization, osteopaenia


Perceptions of Self

■ Loss of autonomy and dignity

■ Changes in self image

■ Guilt


■ Anger

■ Anxiety

■ Depression

■ Fear

■ Sensory deprivation

• Increased confusion

• Disordered sleep

■ Trauma/ retraumatization

Skin integrity alterations

■ Abrasion at restraint site

■ Bruising

■ Development of pressure ulcers

Clinical Management
Promoting Safety: Alternative Approaches to the Use of Restraints
Point of Care Resources