We carry heavy duty, soft on one side, leather restraints for the arms and legs. If necessary, the patient would be immobilized on a long board and fully strapped down. That way, we can do our job, and the patient can't hurt us or hurt themselves. I would prefer that handcuffs not be used, b/c they can still flail around, and we can't leave the cot.. So, if they're on a board, we leave them at the ER and we're done. Less room for lawsuits for the restraints causing problems, they would have no more problem than any other patient on a long board.
If the patient truly cannot control themselves because of a medical condition, either way, it would be uncomfortable for them to lay on cuffs, and like I said, we can't leave the cot, so no purpose cuffing them to a rail. IMO, that makes it more difficult to access them, b/c you know they'll be pissed off, and probably won't cooperate with us. If we can make them comfortable and provide a neutral, judgment free environment, I feel that we can get them the help that they need. I know some don't care, but a little respect goes a long way. Then again, it all depends on the patient and what they did, some LEO's will refuse to uncuff the patient even if it does hinder our exam process.
Two words:
Spit Socks. Get them.