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dc.contributorKnott, J.en_US
dc.contributorGerdtz, M.en_US
dc.contributorDobson, S.en_US
dc.contributorDaniel, C.en_US
dc.contributorGraudins, A.en_US
dc.contributorMitra, B.en_US
dc.contributorBartley, B.en_US
dc.contributorChapman, Paulineen_US
dc.description.abstractObjective To determine current clinical practices for managing behavioural emergencies within Victorian public hospital EDs. Methods A multi‐centre retrospective study involving all patients who attended ED in 2016 at the Alfred, Ballarat, Dandenong, Geelong and Royal Melbourne Hospitals. The primary outcome was the rate of patient presentations with at least one restrictive intervention. Secondary outcomes included the rate of security calls for unarmed threats (Code Grey), legal status under the Mental Health Act at both the time of ED arrival and the restrictive intervention, and intervention details. For each site, data on 100 patients who had a restrictive intervention were randomly extracted for indication and methods of restraint. Results In 2016, 327 454 patients presented to the five EDs; the Code Grey rate was 1.49% (95% CI 1.45–1.54). Within the Code Grey population, 942 had at least one restrictive intervention (24.3%, 95% CI 23.0–25.7). Details were extracted on 494 patients. The majority (62.8%, 95% CI 58.4–67.1) were restrained under a Duty of Care. Physical restraint was used for 165 (33.4%, 95% CI 29.3–37.8) patients, 296 were mechanically restrained (59.9%, 95% CI 55.4–64.3), median mechanical restraint time 180 min (IQR 75–360), and 388 chemically restrained (78.5%, 95% CI 74.6–82.0). Conclusions Restrictive interventions in the ED largely occurred under a Duty of Care. Care of patients managed under legislation that covers assessment and treatment of mental illness has a strong clinical governance framework and focus on minimising restrictive interventions. However, this is not applied to the majority of patients who experience restraint in Victorian EDs.en_US
dc.description.provenanceSubmitted by Gemma Siemensma ( on 2020-08-05T01:15:56Z No. of bitstreams: 0en
dc.description.provenanceApproved for entry into archive by Gemma Siemensma ( on 2020-08-10T08:37:25Z (GMT) No. of bitstreams: 0en
dc.description.provenanceMade available in DSpace on 2020-08-10T08:37:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2020en
dc.titleRestrictive interventions in Victorian emergency departments: A study of current clinical practice.en_US
dc.typeJournal Articleen_US
dc.bibliographicCitation.titleEmergency Medicine Australasiaen_US
dc.subject.healththesaurusBEHAVIOURAL EMERGENCIESen_US
dc.subject.healththesaurusCHEMICAL SEDATIONen_US
dc.subject.healththesaurusMECHANICAL RESTRAINTen_US
dc.subject.healththesaurusPHYSICAL RESTRAINTen_US
dc.subject.healththesaurusRESTRICTIVE INTERVENTIONen_US
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