# KED Advice, Problems, Suggestions



## mcalinux (Dec 12, 2009)

What do you guys think of the KED?  Its a little overwhelming for me and I dread being in the situation where its necessary for me to use this.  Am I the only one who feels this way?  How often do other use this? And how often have you run into problems with KED?


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## Micro_87 (Dec 12, 2009)

The KED Board takes some time to get use to but when you do master it, it can come become a great tool. One thing my instructor told us back in class is an acronym to remember how to strap the pt in, "My Baby Looks Hot Tonight".

M-Middle Strap
B-Bottom Strap
L-Legs
H-Head
T-Torso Strap 

I hope this might help you, it did for me.


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## Lifeguards For Life (Dec 12, 2009)

mcalinux said:


> What do you guys think of the KED?  Its a little overwhelming for me and I dread being in the situation where its necessary for me to use this.  Am I the only one who feels this way?  How often do other use this? And how often have you run into problems with KED?



What about the KED is giving you problems? The KED is a very simple tool though I have seen people have extreme difficulty in it's application. The straps are color coded and i have seen people buckle different colored straps together.

The "My baby looks hot tonight- middle bottom legs head top" is a great mnemonic to employ to keep you organized. It stems from back in the old day when all the straps were greenh34r:. You don't actually HAVE to put the straps in in that order, but if you do it makes life a whol lot more simple
Make sure you really cinch down on the straps. push the strap through the buckle, while pulling it out the other side, if that makes sense, you really need for the straps to be tight. Check that your patient still has pulse, motor and sensory functions.
After you have your patient strapped in, when you lift them, make sure someone supports their legs so the leg straps aren't cutting off femoral circulation. when you lie down the patient make sure you unbuckle the leg straps(especially if it is a dude patient). and once the patient is lying down on a backboard, go ahead and loosen the chest straps.  Repeat PMS evaluation

The KED really is simple, a little extra practice, and I am sure you will be able to master it.


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## Mountain Res-Q (Dec 12, 2009)

IMHO, KEDs are a wonderful tool that are underused (in my area at least and from what I hear, all over the place).  They are underused because even if you use them, you will back it up by placing the patient on a Long Board, so in the minds of many "Why not just skip the first step and move right to the long board and save me some time and some of my energy?"  I do not agree with this attitude, in face I find it to be pure crap; an attitude that has no place in those claiming to be providing the best care for patients.  The KED was invented and is carried by Ambos and Engines because it has a legit use and should be used whenever a seated patient (or otherwise contorted and/or confined) is encountered and manipulation of the body will be required to manuver them out of their present position and onto a long board.  For instance, how do you get a patient out of the drivers side seat at a MVA?  Too many Responders make what is in my mind a huge error in judgement... they decide to skip the KED and attempt to move the patient into a position better suited to the desires of the Responders.  In doing so they put the patient at risk that is unjustified.  Truely, there is no way to justify this.  If there was sufficient cause to board the patient, THEN DO IT RIGHT!!!  Short Board them prior to moving them in potentially dangerous ways and then you can more safely move them onto a long board...  Except in cases of Rapid Extrication.  With that in mind, I am gonna do something CRAZY and quote Rid:



> What I find interesting is so many claim to be good practitioners and follow treatment protocols to the letter "T". These are the same ones that always claim to "do basics before advanced" etc., etc... Yet, they will not use an indicated extrication device that has proven to prevent further injuries to the patient while extricating them?
> 
> I don't/won't say that they do not know how to use them, almost every one practices over and over. Let' s call it as is.... L-A-Z-Y ! Would one not splint to prevent further injuries?
> 
> ...



As far as you being uncomfortable with the KED... sorry, you had better do something about that.  If you want to provide the best possible care to your patients then you NEED to be 100% familiar with every skill you can perform and every piece of equipment you are allowed to use or carry.  Train on it, train on it, train on it... get comfortable and actually use them in real life...

Other threads to review:
http://www.emtlife.com/showthread.php?t=5551
http://www.emtlife.com/showthread.php?t=8830
http://www.emtlife.com/showthread.php?t=10451


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## WarDance (Dec 12, 2009)

Another great consideration for KED usage is a pt. that is sitting up when found, positive for trauma but airway might be occluded if laying down.  Think hit in the head at a construction site or something and is now bleeding from the mouth.  

I've never done it for a situation like that one but I have heard about them.


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## Mountain Res-Q (Dec 12, 2009)

WarDance said:


> Another great consideration for KED usage is a pt. that is sitting up when found, positive for trauma but airway might be occluded if laying down.  Think hit in the head at a construction site or something and is now bleeding from the mouth.
> 
> I've never done it for a situation like that one but I have heard about them.



Another one was something I encountered...  Extremely claustrophobic patient that was so freaked out by by the confinment of the collar, board, head bed, and straps that he started to get violent.  Extreme thoracic spinal pain following a crash and back boarding was warrented.  Had the patinet on the Long Board when we convereted to a KED.  While the Medic was not happy with it, he was transported in a KED and sitting upright on the gurney.  Not the optimal way to approach a potential spinal injury, but you gotta do what you gotta do.


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## WarDance (Dec 12, 2009)

Mountain Res-Q said:


> Another one was something I encountered...  Extremely claustrophobic patient that was so freaked out by by the confinment of the collar, board, head bed, and straps that he started to get violent.  Extreme thoracic spinal pain following a crash and back boarding was warrented.  Had the patinet on the Long Board when we convereted to a KED.  While the Medic was not happy with it, he was transported in a KED and sitting upright on the gurney.  Not the optimal way to approach a potential spinal injury, but you gotta do what you gotta do.



In my opinion being in a KED is so much worse than a board!  The KED is one thing I NEVER volunteer to have put on me!


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## NomadicMedic (Dec 12, 2009)

The KED is also a great way to immobilize an unstable pelvis...and they work great for immobilizing kids, if you don't have a pedi-board.

It's a great tool, I just never use it for what it was designed for.


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## medichopeful (Dec 13, 2009)

WarDance said:


> In my opinion being in a KED is so much worse than a board!  The KED is one thing I NEVER volunteer to have put on me!



Trying having both put on you at the same time.  Not too fun h34r:


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## medichopeful (Dec 13, 2009)

Micro_87 said:


> The KED Board takes some time to get use to but when you do master it, it can come become a great tool. One thing my instructor told us back in class is an acronym to remember how to strap the pt in, "My Baby Looks Hot Tonight".
> 
> M-Middle Strap
> B-Bottom Strap
> ...



I was taught it in a different order ("My Baby Looks Looks Too Hot"):
Middle
Bottom
Legs
Top
Head


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## mycrofft (Dec 13, 2009)

*One good way to learn: be the subject.*

 Really brings it home. I was KED'ed and it was a real revelation,great tool. 
My observation from KED, short and long board experience is that as long as strap A is buckled to strap A etc., and you check the tension on them all, it will work out fine. Follow your local protocols,  but no matter what they are, the keys are practice, communication, and taking the seconds to check before you go.


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## mct601 (Dec 14, 2009)

I've been KED'd and longboarded as an example in class, and I'd rather be KED'd. However, neither situation was fun. I got picked up in the KED and got picked up/spun upside down on the board.  The firefighters taking the class did it to demonstrate just how secure the straps were.  People were laughing, I wasn't at the time lol


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## Deltachange (Dec 14, 2009)

medichopeful said:


> I was taught it in a different order ("My Baby Looks Looks Too Hot"):
> Middle
> Bottom
> Legs
> ...



As was I, the instructor said that there was a risk they could move their bodies, and exacerbate a cervical injury because the head is immobilized. So anyone want to clarify this as I am only just finished with my class, and I have no experience.


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