Magazine article Corrections Forum

What If Someone Is Just Too Big?

Magazine article Corrections Forum

What If Someone Is Just Too Big?

Article excerpt

Since you will be aware of the size problem when he arrives on the unit you need to plan in advance for potential problems. Sometimes, because of the extreme difficulty in handling such a person, staff members wait too long before beginning their intervention; that can make things even more difficult. Here are some "Stay One Step Ahead" suggestions.

Remove others from the area early. This may reduce both the likelihood and seriousness of his behavior.

Call for additional help to be used as a "show of force." This ' means they won't really put their hands on the person, but hopefully the extra presence will have a calming effect. just have them be quiet and stand by, with no extra words or chaos.

Try to get this person to voluntarily move to a quiet room early in the process. Giving someone special permission to request a quiet space is sometimes all that is necessary for him to become involved in his own treatment and make him feel special.

Very large people generally are at increased risk for physiological complications, such as heat ' exhaustion or heat stroke, respiratory arrest, and cardiac arrest, to say nothing of the constellation of co-occurring health problems such as diabetes, etc. Therefore, it is essential to have a physical work-up and a physician's authorization to restrain before the person is brought to the unit.

Assign a staff to monitor vital signs during any hands-on event, and you will want to document this assignment in advance as well as on the restraint form for each incident. There is an added risk of orthopedic injury to staff members who may be responsible to lift, carry, or otherwise physically manipulate such a large person. Thought needs to be given to what you are asking employees to achieve. Please involve your Safety Officer, your Risk Manager and/or your HR department to help you develop an organizational response to these situations.

If the girth is too large for staff to reach around the body, the only inhouse answer is to use a protective canvas blanket, lined with a soft cotton insert-and a team of staff trained in its use. This would probably take a special doctor's order and may involve a rights team and legal counsel. We have used such a blanket in the past and it can be quite effective for containment issues, but staff vulnerability issues still exist. The heavy weight is still a risk to staff members who might have to lower the person to the floor or transport to another area.

You must weigh the safety of this person against the safety of other people being served-staff and officers. …

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