A prospective, observational study comparing mittens versus wrist restraints in critically ill patients.

This is a prospective observational study conducted in the Intensive Care Unit of a tertiary care hospital. The study aims to compare mittens and wrist restraints in critically ill adult patients who require physical limb restraints as part of routine ICU care. All consecutive adult patients of age 18 years and above, who require physical restraints for the first time during their ICU admission will be included in the study during the study period. Patients expected to have an ICU stay of less than 24 hours will be excluded.

The primary outcomes are incidence of unplanned device removal and incidence and severity of restraint site injury assessed using a standardized grading scale. Secondary outcomes include total daily dose of sedative and analgesic medications and number of sedation-free days during the restraint period. Data will be collected prospectively from routine clinical and nursing records without any modification of patient management. Each patient will be followed until discontinuation of restraints, ICU discharge, or death, whichever occurs first.