NEED help using the KED

[jspinos]

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

 

[triemal04]

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.

 

[jspinos]

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?

 

[triemal04]

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.

 

[silver]

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

 

[DisasterMedTech]

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.

 

[medicdan]

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...

 

[skyemt]

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...

 

[medicdan]

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?

 

[Guardian]

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?

 

[Grady_emt]

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.

 

[Ridryder911]

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

 

[rgnoon]

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.

 

[Gbro]

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.

 

[Gbro]

Check out the placement

 

[rgnoon]

Check out the placement

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

 

[Guardian]

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.

 

[Ridryder911]

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

 

[reaper]

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!

 

[medicdan]

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?