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D.C. Municipal Regulations (Last Updated: September 13, 2017) |
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Title 22. HEALTH |
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SubTilte 22-A. MENTAL HEALTH |
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Chapter 22-A5. USE OF RESTRAINTS AND SECLUSION |
Section 22-A503. RESTRAINTS GENERALLY
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503.1Restraints shall include devices and techniques designed and used to control a consumer's behavior in an emergency.
503.2Methods of restraint that may be prescribed in an emergency for consumers receiving services from an MH provider identified in § 500.7 of this chapter include:
(a)Four-point restraints;
(b)Five-point restraints;
(c)Physical Holds;
(d)Legally mandated restraints;
(f)Medical restraints; and
(g)Drugs used as a restraint.
503.3Four-point restraints are the use of soft bracelets encasing the wrists and ankles of a consumer lying on a bed (face up unless medically contraindicated), which are secured to the bed frame. Only restraint devices approved by the federal Food and Drug Administration for four-point restraints may be used.
503.4Five-point restraints are a four-point restraint with the addition of a strap, which is placed over the consumer's upper torso and under the arms and secured to the bed frame.
503.5A physical hold is the application of physical force by a staff person without the use of any mechanical device, for the purpose of restraining the free movement of a consumer's body. A physical hold does not include briefly holding without undue force a consumer in order to calm or comfort him or her, or holding a consumer's hand to safely escort him or her from one area to another.
503.6Legally mandated restraints are the mechanical restraint of an adult consumer during transport from a hospital to District of Columbia Superior Court or Federal Court or to a facility outside of the hospital, applied in accordance with the order of a U.S. Marshal, a judge or other law enforcement official or forensic services policy.
503.7Medical restraints are the short-term use of physical restraint to facilitate completion of an emergency medical or surgical procedure. Medical restraint is limited to the duration of the emergency medical or surgical procedure.
503.8A drug used as a restraint is a medication that is used to control extreme behavioral symptoms during an emergency. Drugs administered to a consumer on a regular basis as part of the consumer's regular prescribed medical regimen to treat mental, emotional or behavioral disorders or to assist the consumer in gaining self-control in accordance with the consumer's service plan shall not constitute the use of a drug as a restraint, even if the purpose of the drug is to control ongoing behavior.