Restraint Notes

The restraint note should document that less restrictive measures were attempted and failed or were considered, but not appropriate for the urgent clinical situation.

Example Restraint Note

Date/time/writer:

The patient became agitated and without provocation, threw a chair and threatened several patients verbally. He was unmanageable to the extent that immediate 4-point restraints were required. Other less restrictive measures, such as locked seclusion, were considered but deemed inappropriate given his severe agitation and assaultive behavior. He will be observed per protocol and may be released at staff's discretion. He will be given haloperidol (Haldol) 5 mg IM and lorazepam (Ativan) 2 mg IM because he has refused oral medication.

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