When my son was almost two, I took him to a specialist who strapped him into what his nurse called a papoose board to administer eyedrops. My son had never resisted or struggled during a medical exam but this doctor assumed he would because he had other pediatric patients with Down syndrome and always used a restraint board with them to avoid any problems.
At the time, I was so concerned about the health of my son's eyes, the restraint board barely registered with me. But he was so distressed about being restrained, when he was released he climbed into my arms and clamped onto me as if he would never let go. He buried his head in my shoulder and would not move from that position. I told the doctor and his nurse that this was uncharacteristic behavior, and they both looked at me like they had heard it all before from other moms of 'uncooperative' children with Down syndrome.
Responsible and humane medical professionals are aware of the distress that 'passive restraints' can have on children and use them as briefly as possible when an injured or frightened child is unable to stay still enough for an emergency treatment, and for very short procedures with local anesthesia without the risks of general anesthesia. Another alternative, having parents and staff physically restrain the child, can be physically dangerous for everyone involved. Parents should be available to support, encourage and soothe their child rather than holding them down.
Companies do advertise restraint boards as items 'to immobilize a non-compliant child or adult during dental work, medical imaging, or minor surgery procedures.' It is too easy to stereotype children like my son as non-compliant when they are actually reacting to the unpleasantness of what happens to be an uncomfortable and unnecessary restraint.
Identifying a pediatric or adult as 'non-compliant' disregards the rights of patients with developmental disabilities who may not be able to communicate their symptoms, pain or discomfort or manage the behavior that results. The original restraint boards are said to have been created for paramedics to immobilize children with possible spinal injuries. Manufacturers found a bigger market in medical and dental clinics.
The added stress of being restrained and frightened can cause children to feel pain more sharply and heal more slowly after a procedure. Offices where child patients with disabilities are routinely described as 'non-compliant' are more likely to use restraint boards improperly and without giving their patients the time or comforting words that might persuade them that the restraint is unnecessary. Restraints are more likely to be too tight or applied improperly by poorly trained or prejudiced staff.
Many Native Americans resent medical restraint boards being referred to as papoose boards because they are nothing like traditional baby carrier cradles worn by parents that comfortably wrap and support babies and young children.
Confronting stereotypes on two levels, we as parents should carefully monitor every medical procedure and dental visit to avoid our children being subjected to restraint for the convenience of professionals who should not engage in stereotyping children with disabilities and offer alternatives when any young patient is frightened or in pain.
Browse at your public library, local bookstore, or online retailer for books like:
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Pain Management for Children with Disabilities
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ABCD: Access to Baby and Child Dentistry
Dental techniques protect teeth and put kids at ease
Knee to Knee Dental Exam for Small Children
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