Development of an inflatable restraint system for rear seat occupants. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Impact tests of a near-production air cushion restraint. Final report.

National Highway Traffic Safety Administration, Office of Vehicle Structures Research, Washington, D.C.

Restraint systems evaluation program. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Sled tests of the air bag - crushable dash-kneebar passive restraint in the Volvo 244. Final technical report.

National Highway Traffic Safety Administration, Washington, D.C.

International technical conference on experimental safety vehicles. Thirteenth. Proceedings. Volume II.

Mode of access: Internet.

Development of a solid propellant inflation technique for the subcompact car passenger restraint system. Phase I final report.

National Highway Traffic Safety Administration, Washington, D.C.

Research safety vehicle - phase II. Volume II: comprehensive technical results. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Evaluation of occupant protection devices and restraint systems. Test report.

National Highway Traffic Safety Administration, Washington, D.C.

Development and evaluation of Hybrid III multi-point thoracic deflection measurement sensors. Final report.

Mode of access: Internet.

Passive restraint systems; a bibliography.

Mode of access: Internet.

Vehicle integration and evaluation of advanced restraint systems - restraint systems analyses. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Vehicle integration and evaluation of advanced restraint systems. Phase A - test report: Volvo-to-Volvo [and] Volvo-to-barrier test.

National Highway Traffic Safety Administration, Washington, D.C.

Cost estimates of automatic crash protection in 1987 model year passenger cars. Volume III. Final report.

National Highway Traffic Safety Administration, Office of Vehicle Safety Compliance, Washington, D.C.

Part 1. Chemical and Physical Restraints in the Management of Mechanically Ventilated Patients in the ICU: Contributing Factors

Chemical and physical restraints are frequently used in the intensive care unit (ICU) to control agitated patients and to prevent self-harm and unplanned extubations. Published work relating to the numerous issues of the care and treatment strategies for these patients remains conflicting and unclear. Literature regarding sedation and chemical restraint reveals a trend towards management with lighter sedation, use of sedation assessment tools and sedation protocols. It remains unclear which treatment is best for agitated and delirious patients, and the evidence on the effect of sedation is conflicting. A large portion of the literature on the use of physical restraint is from general hospital wards and residential homes, and not from the ICU environment. The purpose of this paper is to provide a summary of the existing literature on the use of physical and chemical restraints in the ICU setting. In Part 1 of this two-part paper, the evidence on chemical and physical restraints is explored with specific focus on definition of terms, unplanned

Part 2. Chemical and physical restraints in the management of mechanically ventilated patients in the ICU: A patient perspective

An important goal of the care for the mechanically ventilated patient is to minimize patient discomfort and anxiety. This is partly achieved by frequent use of chemical and physical restraints. The majority of patients in intensive care will receive some form of sedation. The goal and use of sedation has changed considerably over the past few decades with literature evidencing trends toward overall lighter sedation levels and daily interruption of sedation. Conversely, the use of physical restraint for the ventilated patient in ICU differs considerably between nations and continents. A large portion of the literature on the use of physical restraint is from general hospital wards and residential homes, and not from the ICU environment. Recent literature suggests minimal use of physical restraint in the ICU, and that reduction programmes have been initiated. However, very few papers illuminate the patient's experience of physical and chemical restraints as a treatment strategy. In Part 1 of this two-part review, the evidence on chemical and physical restraints was explored with specific focus on definitions of terms, unplanned extubation, agitation, delirium as well as the impact of nurse–patient ratios in the ICU on these issues. This paper, Part 2, examines the evidence related to chemical and physical restraints from the mechanically ventilated patient's perspective.