Physical restraints in emergency departments (EDs) are used to keep staff and patients safe, but may lead to adverse physical consequences, such as aspiration, physical trauma and psychological harm of the patient. A team of researchers has observed that patients of color, specifically Black patients, seemed to be physically restrained in the clinical setting more than other patients. As a result, the team conducted a study, published in JAMA Internal Medicine, that reveals adult Black patients were significantly more likely to be restrained in EDs compared with all other ED patients.
," said Dr. Vidya Eswaran, corresponding author of the paper and assistant professor of emergency medicine at Baylor."The small number of studies included in this review are of mixed quality and reveal that the assessment of race-based disparities in physical restraint use in the ED is understudied."
There were several limitations to the analysis. First, only 10 pieces of text fit the teams' parameters and were used in the review. The definition and categorization of racial and ethnic identities varied across studies, as well as whether hospital staff identified the race or ethnicity of the patient or if the patient self-identified. The team also chose to use completed studies or abstracts that were available in English.
More effort is being put into collecting data on this subject, and scholars with expertise in systemic racism and health equity have developed guidelines for reporting and investigating racism in health care settings. However, Eswaran said more studies on this topic are needed. "Showing that differences in restraint use exist is not enough. We must now further assess the mechanism for why these differences occur and what can be done to prevent them from persisting," Eswaran said.Vidya Eswaran et al, Racial Disparities in Emergency Department Physical Restraint Use,
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