1. (1) The division shall prohibit the utilization of foot manacles.

2. (2) Physical restraints may be utilized beyond one-half hour only in the case of vehicular transportation where such utilization of physical restraints is necessary for public safety.

   (b) Medical restraint.

   For the purposes of this Part, medical restraint shall mean medication administered either by injection or orally for the purposes of quieting an uncontrollable child.

3. (1) Medical restraint shall be administered only in situations where a child is so uncontrollable that no other means of restraint can prevent the child from harming himself.

4. (2) Medical restraint shall be authorized only by a physician and be administered only by a registered nurse or a medical doctor.

   (c) Prn orders of psychiatric medication.

   A pro re nata order, authorizing a registered nurse to administer prescribed psychiatric medication, for purposes of crisis intervention, may be used by the Division for Youth pursuant to the following guidelines:

5. (1) Prescription by medical doctor. Before any Prn order may be prescribed, a medical doctor must examine the child and determine the need for such an order in terms of the individual child's ongoing treatment needs at the facility. These Prn orders shall be prescribed on an individual basis and shall not be prescribed pro forma to all children at the time of their arrival at a facility, as follows:

   1. (i) The medical doctor must sign the order and the medical doctor must provide specific instructions and guidelines for the nurse.
   2. (ii) Periodic review of all Prn orders must be made by a medical doctor, monthly, including physically examining the child.
   3. (iii) At the time of the periodic review, the medical doctor must indicate, in writing, reasons for his continuing the Prn order.

6. (2) Administration by registered nurse. A registered nurse may administer a Prn order when the actions of the child clearly present a danger to himself or other residents, as follows:

   1. (i) She must physically examine the child and refer to the child's medical record including the specific instructions left by the medical doctor for utilization of the Prn order.
   2. (ii) The pulse and blood pressure of children receiving such medication must be taken during the first half hour by the nurse and periodically thereafter until his release.
   3. (iii) The nurse must keep a record indicating the results of those examinations and shall prepare a medication report indicating reasons giving rise to her dispensing the medication.

   4. (iv) If the initial or subsequent examination by the nurse reveals the development of any symptoms indicating an adverse reaction to the medication, she shall immediately notify the medical doctor.

      (d) Reporting requirements.

      Use of physical and medical restraints shall be reported, pursuant to subdivision (j) of section 168.2 of this Part.

(a) Physical restraints.

Permissible physical restraints, consisting solely of handcuffs and footcuffs, shall be used only in cases where a child is uncontrollable and constitutes a serious and evident danger to himself or others. They shall be removed as soon as the child is controllable. Use of physical restraints shall be prohibited beyond one-half hour unless a child is being transported by vehicle and physical restraint is necessary for public safety. If restraints are placed on a child's hands and feet, the hand and foot restraints are not to be joined, as for example, in hog tying. When in restraints, a child may not be attached to any furniture or fixture in a room nor to any object in a vehicle.