Using a Papoose Board for Children

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Sarah K. Lee

A Papoose Board is a device commonly used to immobilize children for dental work, blood-drawing, and minor medical procedures. The child is placed on a flat board and wide fabric straps are wrapped around the upper body, middle body, and legs. The restraints can be applied quickly to keep a child from struggling and resisting treatment. Some parents and professionals feel that this is preferable to other options, such as sedation, or the parent attempting to hold the child down. Others believe that the restraints are traumatizing to children and may add to the terror of an already stressful situation.

In April of 2007, I wrote a blog post about papoose boards that drew 81 comments before the blog for this site was removed. Some readers expressed anger that such restraints are in regular use; some expressed gratitude that there was a way to keep their strong and fighting children still for necessary medical procedures; some shared traumatic experiences from being restrained by papoose boards as children; some shared professionals' point of view; and some objected to the name as a misappropriation of a Native American swaddling tool. The following comment may be useful for giving parents an idea of the options dentists have and what they might ask about:

"I am a pediatric dental specialist and treat very young (average age 3 1/2 ) and special children. We do have a papoose but we rarely use it — only for absolute emergencies, which again is very rare. I have found that the majority of children over 3 years respond well to behavior management techniques. Many who need limited (3-4 teeth) invasive treatment (filling, baby root canal, extractions) do just fine with the addition of nitrous oxide (laughing gas), good behavior management, and local anesthesia. When the treatment needs are greater (many more large cavities, pain, abscess, swelling), I manage the patient with antibiotics and pain meds until I can see them at the hospital, where we complete all the treatment at once under general anesthesia.

"For the very very young children (under 2), I prefer to do the treatment by the knee:knee technique. I find this form of restraint assisted with the caregiver is far better than papoose, and the experience is not nearly as traumatic if at all if children are under 2 (memory is not fully settling) and so long as treatment is done without inflicting pain (ART technique or good local anesthesia with strong topical).

"As for special patients, I find that repetitive exposure over time with the same provider and staff is key to gradual graduation to a cooperative patient." -- Ali, May 10, 2008

Another reader provided some insight as to how papoose boards started as a medical tool in the first place:

"As a paramedic and a fire service history buff, I’ll give you our take on the papoose board. The papoose board was created in the early ’70s as a device to be used by medics to restrain a small child who may have sustained a cervical spine injury, such as from an automobile accident. Smaller children are somewhat harder to strap onto a backboard with a c-collar and head blocks, as they are normally frightened by all that may be going on, so the papoose board was invented to help immobilize a child to prevent any further injury to the spinal cord. It got the name papoose board because of the likeness of a child being swaddled on a Native American cradleboard. It appears that its use has caught on by other medical professionals as well for the restraint of small children during medical care, although not quite what the original intent for use was." -- Dan, June 8, 2009

You can find more information on papoose boards on the following pages:

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