Sec.17a-238-11. Emergency use of physical or mechanical restraint

(a) Physical or mechanical restraint may be employed when an emergency exists in which a person placed or treated under the direction of the commissioner is in jeopardy of harming himself or others and approved individual programs are ineffective to control the situation.

(b) Nonaversive measures shall be attempted first to prevent escalation of the emergency. If such measures are ineffective, emergency use of physical or mechanical restraint may be necessary. No aversive procedure other than physical or mechanical restraint may be employed in an emergency.

(c) Each organization operated, licensed or funded by the department shall establish general written procedures to be used in emergencies. These procedures shall designate supervisory or professional staff who may authorize the use of physical or mechanical restraint in an emergency and shall identify the techniques, devices and equipment which may be used.

(d) A member of the program review committee shall be notified not later than the next working day and shall monitor any continuing use of physical or mechanical restraint until a program is formally approved and commences. Documentation of monitoring shall be maintained in the individual's record.

(e) Whenever physical or mechanical restraint is employed during an emergency, supervisory or professional staff shall examine the individual within twenty-four (24) hours and report any evidence of trauma or injury to the nurse or physician and to the regional or training school director.

(f) The interdisciplinary team, including the physician, shall, within three (3) working days of the use of emergency physical or mechanical restraint, review the individual and his environment to determine if changes are required in his program including the continued use of physical or mechanical restraint or if other behavioral supports should be considered. The interdisciplinary team shall initiate design of a behavioral support plan and the approval process set forth in Section 17a-238-10 of these regulations within five (5) days of the interdisciplinary team review, if:

(1) the interdisciplinary team determines that the continued use of physical or mechanical restraint is necessary; or

(2) the interdisciplinary team proposes the use of other aversive procedures; or

(3) physical or mechanical restraint is used on an emergency basis three (3) or more times in a thirty (30) day period; or

(4) physical or mechanical restraint is used one or more times in three (3) consecutive thirty day (30) day periods.

(g) A report of the interdisciplinary team review, whatever the programmatic outcome, shall be submitted to the program review committee, the human rights committee and the regional or training school director.

(h) Each incident of physical or mechanical restraint used to address an emergency shall be reported in writing to the program review committee, the human rights committee and the regional or training school director within three days of the incident.

(i) Standing orders for the emergency use of mechanical restraint are prohibited.

(Effective November 17, 1994)