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Indian Journal of Forensic Medicine & Toxicology
Year : 2019, Volume : 13, Issue : 1
First page : ( 205) Last page : ( 209)
Print ISSN : 0973-9122. Online ISSN : 0973-9130.
Article DOI : 10.5958/0973-9130.2019.00042.2

Challenge in Management of Aggressive Clients in Psychiatric Setting: Development of Four-Point Physical Restraints

Binil V1,*, Sudhaker Christopher2, Hegde Supriya3, Unnikrishnan B4, Ancheril Alphonsa5

1Assistant Professor-Senior scale, Department of Psychiatric Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal

2Professor of Manipal College of Nursing and Deputy Director of Quality & Compliance, Manipal Academy of Higher Education, Manipal

3Professor, Department of Psychiatry, Father Muller Medical College, Mangaluru

4Associate Dean, Kasturba Medical College, Mangaluru

5Vice Principal, Professor& Head, Department of Psychiatric Nursing, Athena College of Nursing, Mangaluru

*Corresponding Author: Mr. Binil V, Assistant Professor-Senior scale, Department of Psychiatric Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka-576104. E mail id: vp.binil@manipal.edu. Mobile no. 9844387432.

Online published on 8 February, 2019.



The use of physical restraints is a very common procedure in psychiatric setting from the beginning of psychiatry as a branch of medicine. Any measure that keep someone under control is called a restraint. Four-point physical restraints are required for managing clients with mental illness.

Material and Method

The objective of the project was to develop a safe and secure soft limb restraints for aggressive clients. A set of soft limb restraints (two each for upper and lower limbs) was developed along with user guidelines. High quality narrow woven fabric material was selected for preparing the restraints. The restraints were tested in 5 psychiatric hospitals. A 12 item checklist was developed and validated for assessing the user friendliness of the restraints. Necessary modifications were made based on the feedback given by the nurses who tested it.


All the nurses (100%) reported that the developed restraints were easy to apply, easy to remove and met the safety of the clients.


The restraints developed was found to be more safe and operable as compared to other commercially available restraints.



Challenge, management, aggressive clients, restraints.


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