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July 2010, Volume 40 Number 7 , p 9 - 10



When caring for patients recovering from general anesthesia, I always make sure the bed's side rails are up. Recently a coworker criticized me for this, stating that side rails are considered restraints and I shouldn't raise them without an order. Is this correct?—K.L., MD.When side rails are used to "restrict the patient's freedom to exit the bed," they're considered restraints and require an order, according to the Centers for Medicare and Medicaid Services (CMS) interpretive guideline Section 482.13(e)(1)(i)(C). But in limited circumstances when they're used to protect the patient from falling out of bed, they aren't considered restraints under CMS standards. For example, recovery from anesthesia is part of the surgical procedure and raising side rails is appropriate until the patient recovers from the effects of anesthesia. "However, if the intervention is maintained when the patient is transferred to another unit, or recovers from the effects of anesthesia

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