• Posted September 27, 2023

Black Patients More Likely to Be Physically Restrained During ER Visits

It seemed to some that patients of color were being restrained in the emergency room more often than others, so researchers decided to investigate.

While physical restraints can be used to keep staff and patients safe, they may also cause injury to the patient, including aspiration, physical trauma and psychological harm.

A new study bears out what the team from Baylor College of Medicine in Houston suspected: Black patients are more often restrained than patients from all other racial groups. The finding stems from a review of 10 studies published through February 2022.

"The absolute event rate for restraint use was relatively low, less than 1%, but our results suggest that Black patients have a higher risk of restraint than patients of other racial groups,"said corresponding author Dr. Vidya Eswaran, an 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 [emergency department] is understudied."

Researchers cautioned that the studies were each based at a single health-care site, so results may not apply more broadly.

Whether patients self-identified their race or were identified by hospital staff varied from study to study, too, as did the definition of racial and ethnic identities. Researchers said they could not account for factors such as mental health stigma, access to care or pre-hospital interactions.

The findings were published Sept. 25 in the journal JAMA Internal Medicine.

Efforts to collect data on this subject continue, and experts have developed guidelines for reporting and investigating racism in health care settings. But Eswaran said more studies are needed.

"Showing that differences in restraint use exist is not enough," she said in a Baylor news release. "We must now further assess the mechanism for why these differences occur and what can be done to prevent them from persisting."

More information

The National Library of Medicine has more on the use of restraints.

SOURCE: Baylor College of Medicine, news release, Sept. 25, 2023