# NEED help using the KED



## jspinos (Oct 11, 2007)

Hey guys long story short...I took the EMT exam practical back in AUG and failed because I SECURED the head before the body.... for the Spine Immobilization station


If I get the ked again I want to make sure I do it correctly

Last time I did the follow

Once i got the cervical collar on I placed the KED behind the patient and I started to secure the body..... Yellow strap, red strap , legs , Head , then I did the green on last as taught....is this the correct method

I bought an EMT national dvd and the lady on the dvd does the three body straps then legs then head

which way is correct??


Sorry if this isnt in the right forum im a newbie here


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## triemal04 (Oct 11, 2007)

I think that technically (and I mean really technically) securing the third body strap after the rest of the body and leg straps is how it's supposed to be done.  For testing purposes, and for reality, as long as the head is secured last (after all other straps are connected) you shouldn't have a problem.  Just work from the chest to the legs and then back to the head and you should be fine.

I think the reasoning behind leaving the last body strap till later was to limit the amount of time that the the chest was being compressed and limiting breathing.  Hopefully the KED won't be neccasary for long enough to make that a problem, and always remember to loosen the body straps after they're on the longboard.


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## jspinos (Oct 11, 2007)

thanks for the quick response bud ...much appreciated


During the test it ends once the KED is in place and there is no backboard in the station


so you think i should do the first 3 chest straps then the legs then the head and I should be fine?


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## triemal04 (Oct 11, 2007)

Yes.  The head will ALWAYS be secured last and the chest get's done before the body.  So chest-legs-head to make it simple and you'll be fine.


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## silver (Oct 11, 2007)

good old mnemonic phrases. Helped me pass my KED in August
"my baby looks to hot"
middle, bottom, legs, top, head


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## DisasterMedTech (Oct 11, 2007)

Remember too that one of the primary reasons we secure a patients head last is that episodes of vomiting are common to back, spine, neck, etc injuries. So if you remember head last and remember to get those leg straps off as soon as you get your pt on the board or verbalize that you would if you had a board, you should be just fine. Good luck on your next go, Im sure you will kick its butt.

See ya on the street.


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## medicdan (Oct 12, 2007)

Also remeber, if, after securing the head, other straps need to be tightened, you have to undo them in the order they were attached before tightening. 
So, if after securing the top strap, you realize that the middle is loose, you need to undo the entire thing in order to get that stinking thing tight...
I got in a lot of trouble for not doing that at some point...


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## skyemt (Oct 12, 2007)

while you won't have to secure the pt to a longboard, usually this needs to be verbalized, as KED application ends with secureing a pt to a board...

also, be sure not to forget to check PMS on all four extremities before and after applying the KED...
it is usually an automatic failure if you do not do this prior to applying the collar...

do can not got wrong by securing the body, then legs, then head...keep in mind what the examiners want to see... that you maintain spinal immobilization during the entire procedure, that you do not move the pt around too much while applying it, so as to further compromise the spine...

just try to understand what and why you are doing what you are doing, and DO NOT just try to memorize a series of steps...


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## medicdan (Oct 12, 2007)

question: I have longboarded many patients, but yet to use a KED. At what point do you release the leg straps when the patient is on the long board?


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## Guardian (Oct 12, 2007)

What's a KED?  Oh, yea, that thing I was tested on.  Yea, I have no idea because I haven't touched a KED since.  There are situations where I would consider a KED, but they are few and far between.  Any other KED haters on here?


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## Grady_emt (Oct 12, 2007)

Guardian said:


> What's a KED?  Oh, yea, that thing I was tested on.  Yea, I have no idea because I haven't touched a KED since.  There are situations where I would consider a KED, but they are few and far between.  Any other KED haters on here?



Is that whats in that big green sleeve under the bench seat???  Never used it, thought about it once or twice, but it was just easier to kick the door open a little further to get in there.


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## Ridryder911 (Oct 12, 2007)

Grady_emt said:


> Is that whats in that big green sleeve under the bench seat???  Never used it, thought about it once or twice, but it was just easier to kick the door open a little further to get in there.



Okay, with that saying now I am scared! 

How do you treat your patients with cervical, thoracic/lumbar injuries (MVA) with?

R/r 911


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## rgnoon (Oct 12, 2007)

Hey I used the KED just the other day. Had a woman fall down a good number of stairs, c/o of back and neck pain and arm pain . She was basically seated at the bottom of the stairs, so we started with the KED. Then she decided to fake LOC. So we just boarded her and hit the road. Once in the rig we determined that she was wide awake....but the KED WOULD have worked.


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## Gbro (Oct 12, 2007)

emt-student said:


> question: I have longboarded many patients, but yet to use a KED. At what point do you release the leg straps when the patient is on the long board?




When the legs are going to be placed in-line with the body. So bring the pt. into the correct place on the BB/Head immobilizer before releasing legs and resting them down on the board. Keep in mind that this could be a painful maneuver, as the back may arch again with the legs down.

one very important step is to get the Pt. into a natural alignment before starting with the device. If not done properly it will be difficult to imposable to properly secure the head.


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## Gbro (Oct 12, 2007)

Check out the placement


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## rgnoon (Oct 12, 2007)

Gbro said:


> Check out the placement



Now there's a cool idea! Yet another example of McGyver at work in EMS.


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## Guardian (Oct 12, 2007)

Ridryder911 said:


> Okay, with that saying now I am scared!
> 
> How do you treat your patients with cervical, thoracic/lumbar injuries (MVA) with?
> 
> R/r 911



Obviously, when spinal injury is suspected, the KED is appropriate.  With that said, what do you do with all the fender bender "neck pain" calls rid?  Do you use a KED on all of them?  I don't.  I'm not risking my life on the side of the road or breaking my back for insurance fraud.  Is it reasonable to assume a well-educated paramedic can clear c-spine in the field?  I think so, although admittedly, I'd have a hard time convincing anyone with the current state of paramedic education.  Sadly, it seems we are replacing common sense with legal opinion, and allowing lawyers to decide what is best for our patients.  I believe there are very few times when the KED should be considered.  I'd love to hear your thoughts on this issue.

Sorry to hijack the thread jspinos, but using a KED is about the easiest thing we do.  Just follow the instructions in your EMT textbook and you’ll be fine.


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## Ridryder911 (Oct 13, 2007)

I totally agree, until that one patient that has a C-5 or T-2 fxr. When I reentered back into the field I found the KED as well as most immobilization devices were never being used. Yeah, the old slide the board under them and rotate them onto it, and "quote clearing them in the field".  I agree, I too have fallen into that trap.

I agree 90% of the Allstate neck pains are B.S., but I have seen more and more newbies in the field that does not know anything about real C-spine precautions. Why? Because, they do not practice it every day. So when the real thing occurs.. guess what? It take them an additional 5 minutes to place on the device. When that should had never occurred.

As well, not disagreeing; but it would be hard to describe in court why one did not place an immobilization device onto a "neck-back pain" as was taught and recommended and tested under national curriculum. 

I as well, agree that highway safety unfortunately is now mandating on how well our treatment occurs. How wrong is that? Instead of addressing the issue of staging vehicles, closing highways, we have now allowed them to dictate what we do to patients. 

Everyone describes being  big on scene safety. Unfortunately, State Police and LEO have some how became the authority on the scene, only to jeopardize our lives, the patient lives, and anyone else out there. I read where more and more medics are being killed due to this, tragically no one in EMS want to confront this issue, even though this is where we loose the most medics, not some assailant at a scene. Yet, nothing is done about it. 

I have attempted to have administrators, EMS organizations, voice our concerns but all have rejected. Even though within the past five years, we have had at the least 5 Paramedics get killed in my rural state alone; because of foolish scene safety set up by state and local LEO. Apparently, the LEO organizations is much mightier than EMS. 

Sorry for the rant, I totally agree, 

R/r 911


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## reaper (Oct 13, 2007)

Your right Rid. I have had a few scenes that I have fought with troopers about closing down one lane of a highway. They will tell you they are not allowed!
I then remind them that I am in charge of the scene, as long as the pt is on scene. Then explain to them that if the pt or crew is injured because of them being lazy, that they will own full responsibility for the whole mess. They will usually do what you want!


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## medicdan (Oct 13, 2007)

My understanding is that several states (including MA) speceficialy dont have protocols for when NOT to observe c-spine precautions, so EMTs are supposed to c-spine any patient who complains of neck/back pain. Specefically they do not want EMT or Paramedics to clear patients in the field. Is this true elsewhere?


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## firemedic1977 (Oct 13, 2007)

I would use the KED if you think it is needed. It better to over use it then to not use it, when you needed it. As for useing it I have seen it done a few ways. But if you start with the chest move down to the legs. Then back to the head. The head is always last. And you undo the legs after you have the pt on the long board.


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## BossyCow (Oct 13, 2007)

KED is the best tool I know of for immobilizing a seated pt. I agree that it can be over-used, but so is much of our insurance protocol immobilization.  My state allows paramedics to clear c-spine in the field.  In wilderness med we are taught to clear c-spine.  The 'precautionary' backboarding of a pt. who is 2 or 3 days out is less of an issue.  Besides, there isn't usually someone else's auto insurance to bill for the injury.


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## Doctor B (Oct 13, 2007)

Gbro said:


> Check out the placement



OMG!!! Please teel me that was not on a real patient and just a joke!!!
The lawyers would have a field day with that one!!
What would you have done if suddenly that patient lost consciousness and became unresponsive! How would you have managed him then? Sure the easy answer would be to flip him over but how long would that have taken to safely do in a moving ambulance? And once you flipped him over where would you have gained IV access with his hands in cuffs behind him? Don't forget that even the most indignant patients have rights too and there are strict guidelines as to how a patient may and may not be restrained. I'm sorry to get on a soapbox about this but being in a big city metro area I've encountered too many horror stories about EMT's losing their licenses and their careers over situations like this when they lose the wrongful death/ negligence case in court.


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## Gbro (Oct 14, 2007)

> OMG!!! Please teel me that was not on a real patient and just a joke!!!



The Knee's you see in the photo belong to a LEO, This cuffed Pt. was having a "BIG MAC ATTACH".

This handy tool is very useful in just such a situation. The cuffs are in the open, I asked the LEO if they were double locked. He stated NO, That went into the report, and having them that visible made for closer monitoring of cuffs. If this Pt. was a veteran at this sort of thing, he may over-tighten cuffs not double locked.

As for accessing pt. in event of becoming unresponsive, That would have been easy, Note how blurry the pic is, This one was wild and the Ked alowed us to not have to sit on this one just to keep in the straps.

The KED straps were not deployed, just the cot straps are being used.
The lower strap is placed over a pillow just below the knee's.


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## jrm818 (Oct 14, 2007)

Since when is face-down an appropriate restraing positioning?  I'm pretty sure thats explicitly forbid in most protocols, or at least highly discouraged in general EMS literature/education.  The problem isn't only the lack of access if the patient goes downhill, or the near impossibility of reliably monitoring thier condition when all you can see is the KED, but also the possibility of positional asphyxia....lungs don't work so well with a lot of body weight on top of them.  Cop or not, that is your patient, and the way that patient is restrained is inappropriate and dangerous


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## jordanfstop (Dec 9, 2007)

Guardian said:


> What's a KED?  Oh, yea, that thing I was tested on.  Yea, I have no idea because I haven't touched a KED since.  There are situations where I would consider a KED, but they are few and far between.  Any other KED haters on here?



I have used it in the field once in about the thirty total immobilization jobs that I've done. Not too bad for the none in about 300 that I know others have done. It was a fellow EMT at a neighbor ambulance corps that we KED'ed. Ugh, it was like twenty-two degrees outside and snowing too. Rear ended on a highway, however, no significant damage to car.


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## feefersmom (Dec 10, 2007)

We were always taught "My Baby Has Good Teeth"  for Middle, Bottom, Head, Groin and Top.  Some say "green teeth", but personally I would mix up Groin with the green strap.  I prefer Good Teeth.


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## medicdan (Dec 10, 2007)

feefersmom said:


> We were always taught "My Baby Has Good Teeth"  for Middle, Bottom, Head, Groin and Top.  Some say "green teeth", but personally I would mix up Groin with the green strap.  I prefer Good Teeth.


Sorry to Hijack the topic, but...
Since we are sharing pneumonics, I learned My Baby (Lucy) Looks Hot Tonight for Middle, Bottom, [Lift (make sure the head is in the right place)], Legs, Head, Top Strap.


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## AntonioEMT (Dec 15, 2007)

*KED (here SED)*

Middle, legs, head.....


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## ErinCooley (Dec 15, 2007)

Middle (all 3 straps) legs then head.

You release legs and loosen straps upon securing the patient to the backboard.


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## Meursault (Dec 15, 2007)

emt-student said:


> Sorry to Hijack the topic, but...
> Since we are sharing pneumonics


Meta-hijack!
I now know that my instructor wasn't alone. "pneumonic" for "mnemonic" is an easy mistake. Silly Greeks.

He also taught us "My Baby Looks Hot Tonight."
After being KEDed multiple times during the course, I feel sorry for our patients. It gave me a deeper understanding of positional asphyxia as well.


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## thowle (Dec 16, 2007)

silver said:


> good old mnemonic phrases. Helped me pass my KED in August
> "my baby looks to hot"
> middle, bottom, legs, top, head


I was taught that it was "My Baby Looks Hot Tonight", for "Middle", "Bottom", "Legs", "Head", and then "Top".

Not exactly positive that the difference between doing the top strap before the head straps is going to differ between a passing and failing score; but I would say just as long as you secure the torso before the head, and ensure you have padding behind the head and all straps are secure, and tight -- you should do fine.


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## MikeTheBlade (Dec 17, 2007)

i just finished EMT-B and they thought us

Bottom Middle legs head Chest        =  boy my legs have cramps

because when you tighten the chest they cannot breath and the first think you do when you put them on a backboard is loosen the chest strap and remove the leg straps.


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## frankie9983 (Dec 30, 2007)

you need to do the two bottom straps first, then the legs, and the top strap last.   good luck and dont sweat it


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## EMTMandy (Jan 7, 2008)

you release the straps after you pivot your patient and their back is ON the longboard. jus make sure someone's holding the legs until that point ^_^


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## Tincanfireman (Jan 7, 2008)

jspinos said:


> If I get the ked again I want to make sure I do it correctly


 
Here's a link from the NREMT site; hope it helps...

http://www.nremt.org/downloads/spinalimmobilizationseated.pdf


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## nodirt (Jan 13, 2008)

*A ked?!*

How about MC-BLT? thats what i used...

middle, chest, bottom, legs, and top...

as far as using the ked's.. i think about them quite frequently actually, they work great with the little old people with poss. broken hips.. just flip that baby upside down and away you go.

B)


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## KEVD18 (Jan 13, 2008)

so it seems to me that everbody that has ever been taught how to use this thing has been taught differently. boy wouldnt it be nice if there was just a little bit of standardization in the education in this field.

anyho, i was taught it this way in basic school:

my- middle
baby- bottom
looks- legs
hot- head
tonight- top

and this way in -p school

my- middle
baby- bottom
looks- legs
totally- top
hot- head


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## MSDeltaFlt (Jan 14, 2008)

Sorry for the late post.

The head is always done last because you never secure the head to anything without securing the torso first for the mere fact that the torso weighs more than the head and takes more effort to prevent any gravity induced manipulation.

That being said, I personally do not like the KED unless either I'm out of LSB's or I'm securing a small PED.  You're only allowed to manipulate the spine one time... period.  It is very difficult to place a KED inside a car (for instance) without over manipulating the spine.  The KED does have it's place and it's uses.  It just doesn't work for me.  I've been able to work around it.

I've been lucky.  On a normal sized adult to a smaller person that is stable where a KED would fit, I've been able to move them out of the car to the LSB maintaining manual/mechanical C-Spine and not manipulating the spine.  On larger adults, the normal around here, the KED won't fit at all and is essentially useless which means you will need help.

On pts that are unstable, regardless of size, I use a rapid extrication technique.  This utilizes a rolled up sheet wrapped around the C-Collar and the shoulders.

Now I'm not saying that I don't use it, I just don't like it.


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## milhouse (Jan 22, 2008)

Heres a link to the videos that i have for the practical exam now they are give you an idea of what to expect and to help prepare. for the exam. 

please only constructive criticism. please dont pick these videos apart, because they've been picked apart already. i hope these videos help you, as they have help a lot of people already. 

thank you and enjoy.

http://youtube.com/profile?user=milhouse5432

there is a KED video in there also.


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## EMTMandy (Jan 22, 2008)

milhouse said:


> Heres a link to the videos that i have for the practical exam now they are give you an idea of what to expect and to help prepare. for the exam.
> 
> please only constructive criticism. please dont pick these videos apart, because they've been picked apart already. i hope these videos help you, as they have help a lot of people already.
> 
> ...



Constructive criticism: Make sure you pad female's chests upon application of a KED :wacko: kinda made me hurt watching it...


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## emtwacker710 (Jan 28, 2008)

they way I was taught, and did it on my practical (and passed), was head stabilization, c-collar,  put the KED behind the pt. secure the 3 torso straps, then the legs, then tighten everything up, then secure the head and backboard or do whatever your situation requires from there


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## BossyCow (Jan 30, 2008)

EMTMandy said:


> Constructive criticism: Make sure you pad female's chests upon application of a KED :wacko: kinda made me hurt watching it...



Have you had one put on yet? The best way to know how to do a KED is to have someone put one on you.  The perspective you gain about what the KED actually does and how it fits will be sooo helpful. And by the way, I've had one on, and felt no discomfort in 'the girls'.


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## EMTMandy (Jan 30, 2008)

BossyCow said:


> Have you had one put on yet? The best way to know how to do a KED is to have someone put one on you.  The perspective you gain about what the KED actually does and how it fits will be sooo helpful. And by the way, I've had one on, and felt no discomfort in 'the girls'.



Yeah as the matter of fact, I've had one on 5+ times in my life. I found it to be uncomfortable even with the padding, particularly in the axillary region (s). It may be a factor of body shape or pain threshold, I don't know. But in any case, I'd say it's only polite to pad those "areas."


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## EMTMandy (Jan 30, 2008)

...Reading back on it, I don't think you were questioning if I had ever had one on? Moment of confusion, Sorry. My statement still stands though.


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## BossyCow (Feb 1, 2008)

I did mean to ask if you had ever had one applied to yourself.  My concern with the idea of padding is that padding is extra material and it shifts. One of the big things we learn/teach in wilderness medicine is the importance of having bracing, splinting and bandaging secure. Maybe I carry enough of my own 'padding' in that area, but I would be hesitant to put anything between the patient's torso and the KED. It's supposed to be snug not comfy.  In our system, we only use the KED as an extrication device and the pt is then secured to a full backboard. For the short period of time spent in the KED, the discomfort is minimal.


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## piranah (Feb 1, 2008)

well i know being a man and have been put in a KED many times...it is extremely painfull especially when the students who are putting it on you forget to undo the pelvic straps when they lay you on the board.........lets just say i let them know very quikly.:wacko:......don't worry im ok...lol


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## MercyEMT2701 (Feb 1, 2008)

My Baby Looks Hot Tonight
Middle
Bottom
Legs 
Head 
Top (chest) So Breathing Is Not Compromised During The Process


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## EMTMandy (Feb 1, 2008)

BossyCow said:


> I did mean to ask if you had ever had one applied to yourself.  My concern with the idea of padding is that padding is extra material and it shifts. One of the big things we learn/teach in wilderness medicine is the importance of having bracing, splinting and bandaging secure. Maybe I carry enough of my own 'padding' in that area, but I would be hesitant to put anything between the patient's torso and the KED. It's supposed to be snug not comfy.  In our system, we only use the KED as an extrication device and the pt is then secured to a full backboard. For the short period of time spent in the KED, the discomfort is minimal.




But the thing is, as long as you position it correctly initally, (snug enough under the arms) and tighten it down adequately there is No shifting whatsoever.  10X more comfortable too.


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## TKO (Feb 2, 2008)

Once again, posting without reading the whole thread...

KED is a great tool, and extremely under utilized.  Has anyone mentioned using it upside down for stabilizing an unstable pelvis?  Works beautifully!

If it wasn't mentioned, just carefully lift your pt by their waistband or whatever item of clothing (mu-mu, or nightgown) enough to slide the KED underneath and into position, making sure that it is upside down.  Then strap it snugly around the pelvis, and that will stabilize your pt for transport on a clamshell nicely.


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## Ridryder911 (Feb 2, 2008)

Wow ! 5 pages of post on the discussion of how to apply a device to remove someone out of a car.... Amazing, it is all the same thing repeated. 

R/r 911


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## TKO (Feb 2, 2008)

well, it just isn't an interesting enough thread to read through.  I went back to see if anyone else noted the usage for pelvic #s and found NoDirt posted it on p.4.

Ok, anyone who lives in the mountains or the northern states may find it useful to know that it can also be used as a decent crazy-carpet in a pinch.  I'll bet noone thought of that.


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## skyemt (Feb 2, 2008)

ok, emt's out there...

you arrive to the scene of the MVA... the pt is sitting in the passenger side of the Police car... he walked over to them after the accident... he is shaken up, but says he feels fine...

you send someone to check the inside of the vehicle, and note that the rearview mirror has been dislodged...

you ask the patient if he was wearing his seatbelt, and he says he "can't remember"... you ask what happened to the rearview mirror, and he can't tell you.  you palpate his neck and back, no complaints of pain, but you do notice a bump developing on the right anterior part of his scalp.

PD says he looked stunned, but walked over to their car with no problem.

KED, or not KED???


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## piranah (Feb 2, 2008)

well...i would say that since he hit his head he must have not been restrained and he could have neck/back injury....now he doesnt complain of any pain but he also has some type of altered LOC from the head injury so you cant trust that he says he has no pain....i would further inspect/palpate his spine and KED him....it wouldnt hurt to do it....but it might if you dont....


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## TKO (Feb 2, 2008)

Well, it is a significant MOI, so immobilization is "required".  The additional deficits only enforce that rule.


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## EMTMandy (Feb 2, 2008)

Ridryder911 said:


> Wow ! 5 pages of post on the discussion of how to apply a device to remove someone out of a car.... Amazing, it is all the same thing repeated.
> 
> R/r 911



It's not our fault someone laced a Dinosaur thread with Training Videos...Frankly I don't think a lot of people would want to read the last 4 pages of fun...


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## BossyCow (Feb 4, 2008)

EMTMandy said:


> But the thing is, as long as you position it correctly initally, (snug enough under the arms) and tighten it down adequately there is No shifting whatsoever.  10X more comfortable too.



Sorry, I'm not going to add in any extra padding for comfort.  The KED is only in place for a short time, and any discomfort is minor. I am what used to be known as 'buxom' and have never had an issue with pain resulting from a KED properly applied. The device is designed to immobilize a patient, backboards aren't too comfy either but they do perform the task for which they were designed. 

I'm not going to be the one on the stand explaining to the attorney why I took it upon myself to change the operation of the device. Seriously, you can't be sure that the padding won't shift while you are 'tightening it adequately' If a KED, properly applied doesn't cause my chest pain, I can't imagine it being so painful as to require a change of protocols from normal application for anyone.


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## EMTMandy (Feb 4, 2008)

BossyCow said:


> Sorry, I'm not going to add in any extra padding for comfort.  The KED is only in place for a short time, and any discomfort is minor. I am what used to be known as 'buxom' and have never had an issue with pain resulting from a KED properly applied. The device is designed to immobilize a patient, backboards aren't too comfy either but they do perform the task for which they were designed.
> 
> I'm not going to be the one on the stand explaining to the attorney why I took it upon myself to change the operation of the device. Seriously, you can't be sure that the padding won't shift while you are 'tightening it adequately' If a KED, properly applied doesn't cause my chest pain, I can't imagine it being so painful as to require a change of protocols from normal application for anyone.



well first of all, litigation would be the last thing on my mind when i was trying to make my patient more comfortable and second, one would think if the extra material raised the odds of further injury So much, there would be a lot more cutting of preexisting clothing going on out there in the field before the application of a KED.  And yes, the patients are only in them for a short time IN THE AMBULANCE but ER waits can last hours... for bonier people like myself that would be terrible as it is.


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## MedicSqrl (Feb 4, 2008)

This is turning into a cat fight. Many times a simple question has turned in to protocol showdown. Just agree that you have different ways of doing it. Believe it or not there are more than one right answer. Yes, padding in a KED, its not going to decrease functionality if you are applying it right or there would be alot for trauma nekkid people. Don't assume your own body type is just like everyone else. Any unnecessary pain is just that..unnecessary. Patient comfort believe it or not is apart of patient care. I know some place don't seem to teach that anymore.


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## EMTMandy (Feb 5, 2008)

I have to disagree with one thing...this is a discussion. not a "cat fight."


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## BossyCow (Feb 5, 2008)

EMTMandy said:


> I have to disagree with one thing...this is a discussion. not a "cat fight."



Now there's a point we can agree on Mandy!

When two women disagree, gotta be a 'Cat fight'?? Sounds like someone needs to review their 'sensitivity training'


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## EMTMandy (Feb 5, 2008)

Yeah...no kiddin'. *Shakes Bossycow's hand*


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## nodirt (Feb 6, 2008)

EMTMandy said:


> Constructive criticism: Make sure you pad female's chests upon application of a KED :wacko: kinda made me hurt watching it...



Hey Mandy,
I see where you are coming from; but, thinking of all of those glorious things we have been taught, "life over limb, seconds matter, etc, etc." Applying a K.E.D. takes long enough, if my pt. is in that bad of shape, I'm not going to waste more valuable time to pad her already padded chest. 2 min. from a short board to a long board; she will be O.K.!


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## EMTMandy (Feb 6, 2008)

nodirt said:


> Hey Mandy,
> I see where you are coming from; but, thinking of all of those glorious things we have been taught, "life over limb, seconds matter, etc, etc." Applying a K.E.D. takes long enough, if my pt. is in that bad of shape, I'm not going to waste more valuable time to pad her already padded chest. 2 min. from a short board to a long board; she will be O.K.!



But you see, a KED is for a "STABLE patient in a seated position..." so if your patient is in such bad shape that you can't take .01 seconds to throw a towel over her chest, then you shouldn't consider KED in the first place. 

p.s. the patient remains in the KED on the long board anyway, so it remains in place until X-rays are taken.  Which means one can not always accurately predict the time they will be left in it.


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## Ridryder911 (Feb 6, 2008)

Personally I may loosen and open the KED chest portion of the device after placement upon the LSB if there is any suspected chest injuries. Remember it is an *extrication device* only. Chances are no matter whom or what you are, your shirt will be removed to examine the chest wall and auscultation to be performed. (that is on really suspected trauma).


For as leaving them on. That is a local issue. Most of our Doc's have been instructed to have the patient off the LSB and KED removed within the first few minutes after entering the room. If there is suspected real injuries, then after x-ray, but usually a clinical clearance is made and off they come. 

Okay this is step by step direction as per DC/EMS as supposedly taken per the NHTSA recommendation. 

R/r 911
http://fems.dc.gov/fems/lib/fems/J13.pdf


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## piranah (Feb 6, 2008)

we are taught to remove the KED or at least take the straps off....because it is just that an EXTRICATION DEVICE......but local protocols vary so whats correct for me isnt correct for someone else....^_^ cant we all just get along lol..jk


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## Topher38 (Feb 9, 2008)

MY BABY LOOKS HOT TONIGHT

Mid strap
Bottom strap
Leg straps
Head
Top 

I always get confused with the last part. Because Im so used to thinking head strapped to the backboard last. But with ked its diffrent. =[ confuses me.


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