# KED Strap Order



## mjg0519

A thought crossed my mind last night, why do we do the straps on the KED device in the order we do (middle, bottom, legs, head, top)? Is there a particular reason for it?

Mike


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## FF894

Something else to be tested on.  And the catchy "my baby looks hot tonight" among others

I am sure that's how the manufacturer designed it to work most effectively to be tight.  The device only works properly if very tight on the body and the order probably has to do with achieving the tightness.  Thats just a guess with no supporting data whatsoever. B)


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## DT4EMS

mjg0519 said:


> A thought crossed my mind last night, why do we do the straps on the KED device in the order we do (middle, bottom, legs, head, top)? Is there a particular reason for it?
> 
> Mike




One of the main reasons for the strap order that comes to mind is this............

Since the KED is a spinal restriction device...... it is made of rigid material. Think of a Teeter Totter form when you were a kid..................

If you attach the bottom strap first.......... what direction would the top of the KED go?

Same if you secured the top strap first.

So in principle............ the middle is the strap that would cause the least amount of shifting or leverage.


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## mycrofft

*Tummy as fulcrum*

If you fasten the head first, as is intuitive, then when you tighten the other straps it affects how tight the head hitch is. If you have the others done first, the head hitch will not need readjustment.
Take a marker and write 1, 2, 3...big contrasting letters, and select a marker which will not degrade the straps.


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## marineman

We were taught a different mnemonic and a different order for securing straps in our basic class. We were taught My Baby Has Great Teeth; middle, bottom, head, groin, top. It works on the same principle of keeping the pressure applied uniform so readjustment isn't needed, just a slightly different order.

P.S. for the national registry the only requirement for strap order is that the torso is done before the head.


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## mycrofft

*Learn the test, then learn the manufacturer's instrux, then what works.*

............


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## daimere

mjg0519 said:


> A thought crossed my mind last night, why do we do the straps on the KED device in the order we do (middle, bottom, legs, head, top)? Is there a particular reason for it?
> 
> Mike


We were told as long as you don't do the head first, you don't have to attach the straps any special order


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## Shishkabob

We were taught top, middle, bottom, legs, head.


Hmph.


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## Ridryder911

If you were taught head first, you were taught wrong. Even by the manufacture and the man who designed it (yes, there is a real person named Kendricks). 

The reason is simple strap any non-movable device upon flexible parts and see what occurs. If you attach the head first, the chest piece will not be able to cinch down. 
*Remember* the sole purpose of a KED is to remove someone as an extrication device.. it is NOT a splint. It is supposed to be extremely tight, for removing the patient and then  after patient is removed can be loosened. 

Middle strap is usually recommended for patient with potential chest injuries and then work caudally (towards the feet or distally) alike one should when applying wrapping/bandaging. Tightness starts at the core and then outwards. 

I suggest to look at the manufacture website. They have description, anything else would be local variances. 

R/r 911


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## MagicTyler

My         Middle
Baby      Bottom
totally    top
looks      legs
hot        head
tonight   tight


That's the way I learned... My instructor had a purpose for putting in the totally, but I can't remember what it was now. I think its because she said people were forgetting the top straps...


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## MRE

My Baby Looks Too Hot

Middle, Bottom, Legs, Top, Head

You really think they would be able to decide on one way for something like this.  Wait, what am I saying; nevermind.


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## BossyCow

Instead of following the order from an internet forum, use the order in your manufacturers instructions. Different models use different order and yes there is a reason for the order. Best way to see the importance of doing it correctly is to take drill time and do in incorrectly to see what happens.


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## akflightmedic

Simple explanation, no need to complicate.

I like the teeter totter analogy.

My Baby Looks Hot Tonight.

Middle to keep device in place.
(You can go ahead and buckle the top strap but do NOT tighten it) This is where people get confused.

Bottom strap.

Since you are down there, do the legs.

Now that the device is in place and secured at the bottom, secure the head as it is not going to alter the placement of the device at this point.

Top...meaning you tighten that chest strap just prior to moving.

You do not want to have that chest strap tight while you are doing the legs and head which are most time consuming, meanwhile your pt is struggling to take full breaths.


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## flhtci01

W1IM said:


> My Baby Looks Too Hot
> 
> Middle, Bottom, Legs, Top, Head
> 
> You really think they would be able to decide on one way for something like this.  Wait, what am I saying; nevermind.



Learned it as My Baby Likes To Hump


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## scottyb

I too was taught Middle, Bottom, Legs, Head, Top.  

I was also taught that, according to our protocols, a extrication device should always be applied in accordance with manufacturer instructions.  So, I guess, If you have one that is different, at least in NY, you apply what ever way that manufacturer says to.


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## WarDance

I think it's because "My baby looks hot tonight" might be the best neumoic in EMS.  Someone in my class also had a dance to go with it!


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## AJ Hidell

WarDance said:


> I think it's because "My baby looks hot tonight" might be the best neumoic in EMS.


Obviously you never took Anatomy & Physiology.

Wait until you get to the cranial nerves.


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## DT4EMS

AJ Hidell said:


> Obviously you never took Anatomy & Physiology.
> 
> Wait until you get to the cranial nerves.




AJ........... you wouldn't be talking about............. Oh,Oh,..........oh well....nevermind! Bwahahaha!

I think you were...........

Kip


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## xgpt

huh...

We were told pretty specifically in my class that it didn't _really _matter what order we did it in...

Does it really?

I live in VA, did the requirements change? Can someone check this? I can't find anything...


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## TransportJockey

xgpt said:


> huh...
> 
> We were told pretty specifically in my class that it didn't _really _matter what order we did it in...
> 
> Does it really?
> 
> I live in VA, did the requirements change? Can someone check this? I can't find anything...



As long as torso is done first, not as much. But it makes sense to do the middle first out of the torso straps.


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## xgpt

Yeah, I'm still going to do the "My Baby Is Hot Tonight" if I ever have to KED someone...

but I was just asking for clarification...I'm not sure why...I'm just used to asking really anal questions for testing purposes.


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## EMSLaw

xgpt said:


> Yeah, I'm still going to do the "My Baby Is Hot Tonight" if I ever have to KED someone...
> 
> but I was just asking for clarification...I'm not sure why...I'm just used to asking really anal questions for testing purposes.



If you follow the on "My baby Lolita" acronym, you'll fail.  While there us no specific order anymore, you now secure the torso completely before the legs.

Basically, you put all the torso straps on, lift, tighten the torso straps, THEN do the legs, then the head, then extricate to the LBB, then release the leg straps.


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## 8jimi8

EMSLaw said:


> If you follow the on "My baby Lolita" acronym, you'll fail.  While there us no specific order anymore, you now secure the torso completely before the legs.
> 
> Basically, you put all the torso straps on, lift, tighten the torso straps, THEN do the legs, then the head, then extricate to the LBB, then release the leg straps.



that's what i have been practicing in my classes


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## Needles17

*ked*

I have found that 99% of ems responders apply the ked improperly.  The straps are not as important as position of the ked itself.  Yes, my baby looks good tonight is a great way to remember it, but most keds are strapped to low on the pt.  The arch of the ked should be pulled up to under the arm pits and wrapped around to the anterior so there is not a void between the head and the ked.  You should never need the padding unless you have an extreme osteoporosis pt.  Try it, you will be amazed.  Just remember to loosen those leg straps when you lay the pt down...


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