NEED help using the KED

[firemedic1977]

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.

 

[BossyCow]

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.

 

[Doctor B]

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.

 

[Gbro]

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.

 

[jrm818]

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

 

[jordanfstop]

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.

 

[feefersmom]

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.

 

[medicdan]

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.

 

[AntonioEMT]

KED (here SED)

Middle, legs, head.....

 

[ErinCooley]

Middle (all 3 straps) legs then head.

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

 

[Meursault]

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.

 

[thowle]

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.

 

[MikeTheBlade]

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.

 

[frankie9983]

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

 

[EMTMandy]

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 ^_^

 

[Tincanfireman]

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

 

[nodirt]

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)

 

[KEVD18]

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

 

[MSDeltaFlt]

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.

 

[milhouse]

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.