5.4.1. 5.4.2. 5.4.3. 5.4.4. 5.4.5. 5.4.6. 5.4.7. 5.4.8. Restraint measures shall include the use of physical force, physical restraint, medication tranquilization, and isolation. A psychiatric organization shall have the mechanical means of physical restraint prescribed by the legislation.  Psychiatric institutions may not use mechanical means not prescribed by the relevant legal act. In some cases, psychiatric institutions were found to be using rubber cords, bed linen, or belts made of hard cloth (not leather) or synthetic material. It is impermissible to use compression [Esmarch's] bandage (tourniquet used for stopping bleeding) as a means of mechanical restraint. The mechanical means of physical restraint shall be easy to release and shall not inflict pain upon the patients. Means limiting harmful impact, which will minimize the continued pain or suffering of persons with mental health issues, are the only means that may be used for mechanical restraint. The measures of restraint shall be used skillfully and with care in order not to pose a threat to the patient's life and health and not to inflict pain upon the patient, and not to violate the patient's basic vital functions such as breathing, speaking, eating, and drinking abilities. A psychiatric organization shall have separated rooms for physical restraint. Physical restraints shall not be used in patient rooms or within sight of other patients. As a rule, security staff performing guard service shall not take part in the restraint activities. They may, as an exception, take part in such activities only in exceptional circumstances, when demanded by the medical personnel, and only insofar as indicated by the medical personnel. The security staff shall not wear special (for example, police uniforms or similar) uniforms, because it can intimidate the patients. 59