When the preliminary prognosis is grim, place your patient in these nylon wrist and ankle cuffs to ensure that they are suitably restrained. Heavy duty metal rivets secure the inescapable metal D-rings in place while the Velcro straps are easy for you to secure but impossible for the patient to remove. A 4.5 inch long metal chain connects each set of cuffs together. Hand or machine washable after use.