Introduction: Mechanical restraint is an exceptional intervention used in patients with severe psychomotor agitation and high-risk behaviors when less restrictive measures have failed. However, conventional thoracic restraint systems lack standardization and may be associated with respiratory complications, mechanical injuries, and medicolegal concerns. The Kendrick Extrication Device (KED), widely used for the extrication and immobilization of trauma patients, possesses structural characteristics that could make it a complementary alternative for trunk stabilization during mechanical restraint. Objective: To evaluate, through a critical review of the available literature and an analysis of the device’s structural characteristics, the feasibility of using the Kendrick Extrication Device as a complementary tool for mechanical restraint in patients with severe psychomotor agitation, while examining its potential benefits, limitations, risks, and clinical, operational, and medicolegal implications. Materials and Methods: A critical narrative review of the scientific literature was conducted, focusing on the KED, prehospital immobilization, mechanical restraint, patient safety, respiratory complications, positional asphyxia, hyperactive delirium, and agitation associated with substance use. In addition, a comparative analysis of the biomechanical and operational characteristics of the KED and conventional thoracic restraint systems was performed. Results: The analysis identified potential structural and procedural advantages of the KED derived from its standardized design and application technique. The reviewed literature reported no neurological deficits attributable to its use, although reductions in certain pulmonary function parameters were described. No clinical studies validating its use as a mechanical restraint device in psychiatric patients or formal recommendations supporting this indication in international guidelines were identified. Conclusions: The Kendrick Extrication Device may represent a complementary alternative for trunk stabilization in selected prehospital emergency settings. Nevertheless, the absence of specific clinical evidence, potential respiratory limitations, and medicolegal considerations currently preclude recommending its routine use. Prospective clinical studies are needed to establish its safety, effectiveness, and evidence-based indications.
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