# EMT-B Practical and splinting of a long bone…



## RunnerD1987 (Jul 6, 2011)

I am taking the EMT exam this Saturday and reviewing what needs to be done. When it comes to long bone saddling the foot I become lost.

So say we have an injury located on the left leg tibia superior to the tarsal
Scene Safe/BSI
Provide Manual Stabilization
Measure Boards/Equipment
Apply Splint/Use Cravats
For joint below and above/Bone below and above
Lay cravat between both legs at the top (Fourth)
Cravat above the patella (Tie First)
Cravat below the patella above the injured site ( Second)
Cravat below the injured site (Third)
Final Cravat is to saddle the foot…Where I become loss

I cannot remember if cravat first goes above or below the foot.
I am thinking cravat goes below, then over the boards, then under the board, then crosses over the foot, and tie on the bottom of the foot.

Second question is the KED
When placing the KED on the longboard do you know what order to strap them in? I am thinking legs, head, and then chest.

Appreciate the response.


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## MrBrown (Jul 6, 2011)

Brown is lost and not sure what you are on about, for isolated extremities we use cardboard splints, for somebody with a nunngered tib/fib/femur we use the Hare traction splint.

If you are referring to tying the legs together, if patient has NOF'd themselves we do pillow between the knees and tie the mid fib, knees and ankles together.


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## RunnerD1987 (Jul 6, 2011)

Appreciate the response. However, it is for an EMT Pratical exam for my cert. this Saturday. Normally have two choices where a joint or bone. The joint is usally the sling and swathe. Then the other is long bone, which is pad the ulna or radial. Sling and swathe it. Then the other long bone is the leg injury bellow the patella. They want you to use boards and crevats to support the leg. The issue is I cannot remember how to saddle the foot for some reason.


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## usafmedic45 (Jul 6, 2011)

> When placing the KED on the longboard do you know what order to strap them in? I am thinking legs, head, and then chest.



Chest, legs and then head although some will tell you chest, head then legs.  Basically, so long as the chest is secured before the head, you should be good.


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## RunnerD1987 (Jul 6, 2011)

usafmedic45 said:


> Chest, legs and then head although some will tell you chest, head then legs.  Basically, so long as the chest is secured before the head, you should be good.



Appreciate the response. Our instructor told us that when using the KED you have to strap them on differently then you would normally on the backboard. It is chest, legs, and head. Thanks.


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## usafmedic45 (Jul 6, 2011)

Right.  As long as the head is not allowed to be secured down while you're maneuvering the torso, you're more or less OK.


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## DesertMedic66 (Jul 6, 2011)

For my EMT and NREMT tests we always used the cardboard splints for a tibia fracture.


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## mycrofft (Jul 6, 2011)

*Again, tell them what they want.*






Yes, head last on KEDS or short spine board or whatever. 
Find and regurg the other. You'll do fine!!!


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## StickySideDown (Jul 11, 2011)

Easy way to remember KED strapping order...

My
Baby
Looks
Hot
Tonight

Middle Torso strap.
Bottom Torso strap.
Legs.
Head.
Top Torso strap.

After tightening the straps make sure your PT is still able to breathe comfortably. Should just be able to get your fingers under the straps.


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## wadford (Jul 13, 2011)

When I was going through my basic class, for the KED we secured the chest first then the legs, adjusting both so that they were tight but not so tight that the pt. couldn't breath. We padded (if necessary) the voids and secured the head last. As far as the long bone of the leg, we used two padded board splints, we seesawed the cravats under the pts. injured  leg while our partner held manual stabilization. One above the knee and one below above the injury. For the foot, the cravat went up, crossed over the foot, bring it under to the sole and cross again before taking it back under the splint and tying on one side.


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## Martyn (Jul 13, 2011)

StickySideDown said:


> Easy way to remember KED strapping order...
> 
> My
> Baby
> ...



Agree with above, just dont forget to undo the leg straps before anything else once PT is on LSB. As for ankle/lower leg arms etc I was always taught distal to proximal on bandaging, splinting etc


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## StickySideDown (Jul 13, 2011)

Martyn said:


> Agree with above, just dont forget to undo the leg straps before anything else once PT is on LSB. As for ankle/lower leg arms etc I was always taught distal to proximal on bandaging, splinting etc




Same always distal to proximal, and always check PMS distal to your splinting, Pulse/Motor/Senseation after doing any splinting ALWAYS.


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## L.anaKnits786 (Jul 22, 2011)

StickySideDown said:


> Easy way to remember KED strapping order...
> 
> My
> Baby
> ...




The first time someone said this to me I thought he was pulling my leg (no pun intended)


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## mycrofft (Jul 22, 2011)

*five is four. And most tibiae are superior to the tarsals.*


If they aren't, someone's been jumpinjg into the shallow water off the highdive again, no?

Re KEDS: see USAFMED above, all else is fiddling.
BTW, how did the test go, OP?


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## Handsome Robb (Jul 23, 2011)

I was taught "titties, tummy, testies" for LSB and KED. If using spiders you do the shoulder straps after the legs, but before the head.

So top to bottom on the torso then the head always comes last. With a KED remember to unhook the leg straps on the KED once they are secured to a longboard unless you want their legs to go to sleep.


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## Strap (Jul 23, 2011)

NVRob said:


> I was taught "titties, tummy, testies" for LSB and KED. If using spiders you do the shoulder straps after the legs, but before the head.
> 
> So top to bottom on the torso then the head always comes last. With a KED remember to unhook the leg straps on the KED once they are secured to a longboard unless you want their legs to go to sleep.



Nipples, navel, knees, noggin.


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