Study reveals disparities in emergency department restraint use by race and ethnicity

A new study that contributes additional data to a growing body of evidence demonstrating disparities in restraint use in the emergency department (ED) has been published in the January issue of Academic Emergency Medicine (AEM), the peer-reviewed journal of the Society for Academic Emergency Medicine (SAEM). The study, titled Disparities in use of physical restraints at an urban, minority-serving hospital emergency department evaluates the association between race/ethnicity and the use of restraints in an ED population at a minority-serving, safety-net institution.

Using chart review methodology, Pino et al. observed a decrease in the odds of restraint use among Black and Hispanic patients compared to White patients in their ED among all adults. However, among patients with a documented history of mental illness or substance use disorder, the investigators found an increase in the use of restraints among female Black and Hispanic patients and among male Black patients (but not male Hispanic patients).

The lead author of this article is Elizabeth C. Pino, PhD, Department of Emergency Medicine, Boston Medical Center and Boston University School of Medicine. Pino et al. conclude that further studies are needed to evaluate the drivers of increased restraint use in patients of color with substance use disorder and mental health diagnoses and whether there are effective strategies to minimize the use of restraints and, when restraints are necessary, assure an equitable application of this intervention.