What does BRP mean in medical terms?

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In the hospital, you might see the abbreviation BRP written under activity in a patient’s kardex or journal.

BRP is a medical abbreviation that stands for “bathroom privileges”. This usually means that the patient has been advised strict bed rest by the doctor, but has permission to use the bathroom facilities when necessary. 

Table Of Contents
  1. History of bed rest
  2. Why it is not widely practiced today
  3. Is bed rest still practiced today?
  4. References

Why would someone need a doctor’s permission to use the bathroom?

Back in the day, it was very common for doctors to order bed rest for patients as a part of their treatment.

For various reasons, it is not commonly practiced today, however, it might still be ordered to pregnant women with high-risk pregnancies and individuals who have undergone certain types of surgery.

It is also worth adding that it can be important to limit patients’ access to the bathroom in certain instances.

One of the most important is in the case of communicable (infectious) diseases. Due to the risk of spreading infection, a doctor might want to limit patient access to the bathroom, especially if it is shared in the ward.

History of bed rest

Bed rest as a treatment can be traced back to the earliest medical writings. The practice was carried onwards in modern medicine and was prescribed as a means of treatment for many diseases.

Throughout the years, bed rest was prescribed for patients with back pain, myocardial infarctions (heart attacks), infectious diseases, and certain complications of pregnancy. Also, back in the 1800s, it was often prescribed for patients with nervous illnesses such as hysteria and anorexia.

In these cases, it was often referred to as the rest cure which was pioneered by American Neurologist Silas Weir Mitchell.

The length of bed rest varied for the different conditions, but in the case of the rest cure, it typically lasted 6 to 8 weeks.

Why it is not widely practiced today

Towards the end of the 20th century, more and more doctors started to question the benefits of bed rest as treatment. Also, much evidence was gathered that showed that bed rest could potentially harm the patient and lead to worse outcomes.

Today, it is widely accepted that prolonged bed rest and inactivity are associated with complications that can worsen patient outcomes.

Most prominently this includes increased risk for deep vein thrombosis (DVT) and pulmonary embolization (PE), pressure ulcers, and pneumonia.

In fact, it is common practice top urge patients to get out of bed as soon as possible after an operation in an effort to prevent DVT and PE. In some cases, patients are even put on blood thinners to prevent this.

In addition to the undesirable complications, systematic reviews have found no evidence that supports that bed rest has any significant beneficial effect when used as a treatment or when used after surgery.

Is bed rest still practiced today?

Due to the potential complications and lack of evidence to support its efficacy, bed rest is largely abandoned in most fields. That being said, it is not uncommon to encounter patients’ ordered to bed rest with bathroom privileges on the obstetrics ward. 

This is because many doctors suggest bed rest in several conditions associated with a high-risk pregnancy, this includes:

  • Growth problems with the baby
  • Maternal high blood pressure or preeclampsia
  • Vaginal bleeding from placenta previa or abruption
  • Preterm labor
  • Cervical insufficiency
  • Threatened miscarriage

According to a WebMD article, up to 1 in every 5 women is on restricted activity or bed rest at some point during her pregnancy in the hope that taking it easy, lowers the risk of preterm birth or pregnancy complications.

Like in most other fields, the practice of bed rest during pregnancy is gradually being abandoned and is no longer recommended for most conditions.

In addition to the obstetric ward, bed rest might be prescribed after certain surgical interventions. While there might be individual cases here and there, it is most notably practiced after certain spine surgeries.

References

  1. Guidelines for Environmental Infection Control in Health-Care Facilities (2003): https://www.cdc.gov/infectioncontrol/guidelines/environmental/index.html
  2. C Allen, P Glasziou, and C Del Mar. Bed rest: a potentially harmful treatment needing more careful evaluation. Lancet. 1999 Oct 9;354(9186):1229-33. https://www.ncbi.nlm.nih.gov/pubmed/10520630
  3. Rest cure: http://broughttolife.sciencemuseum.org.uk/broughttolife/techniques/restcure
  4. D. K. Dittmer and R. Teasell. Complications of immobilization and bed rest. Part 1: Musculoskeletal and cardiovascular complications. Can Fam Physician. 1993 Jun; 39: 1428-32, 1435-7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2379624/
  5. D. K. Dittmer and R. Teasell. Complications of immobilization and bed rest. Part 2: Other complications. Can Fam Physician. 1993 Jun; 39: 1440-2, 1445-6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2379609/
  6. Martin O’Donnell and Jeffrey I. Weitz. Thromboprophylaxis in surgical patients. Can J Surg. 2003 Apr; 46(2): 129–135. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3211697/
  7. WebMD Medical Reference. Does Bed Rest During Pregnancy Really Help? August 04, 2018. https://www.webmd.com/baby/guide/bed-rest-during-pregnancy#1
  8. MayoClinic. Bed rest during pregnancy: Get the facts. March 31, 2017. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy/art-20048007
  9. Rex A. W. Marco, MD, Ryan M. Stuckey, MD, and Stephanie P. Holloway, MHA1. Prolonged Bed Rest as Adjuvant Therapy After Complex Reconstructive Spine Surgery. Clin Orthop Relat Res. 2012 Jun; 470(6): 1658–1667. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3348306/