Standing takedown, KED......

[lightsandsirens5]

From a third party trainiee.

How would any of you handle this:

13 y/o female, fell off playground equipment. She is sitting in a chiar that has no armrests. States she fell about 5 feet, hit her head on the ground and is c/o some neck and back pain in addition to some pain in R arm. We began manual stabilization(spelling?) and put a c-collar on.

OK, now how would you get her onto the backbord?

Any thoughts?:huh:

 

[MRE]

Based on the fact that she is complaining of pain in the neck and back, and that it would be real easy to put a KED on, that is probably what I would do.

Stabilization, visual exam of the head and neck, collar, exam of the rest of the body, KED, backboard, transport.

 

[lightsandsirens5]

That is what I thought, but the primary crew stood her up and did a standing takedown.

??????

 

[Grady_emt]

She was already ambulatory PTA EMS as she was relocated from the playground to the chair, possibly why they did the standing, KED would be super appropriate if you wished.

 

[JJR512]

She was already ambulatory PTA EMS as she was relocated from the playground to the chair, possibly why they did the standing, KED would be super appropriate if you wished.

I was taught that just because the patient moved or has been moved already without apparently exacerbating any injuries, doesn't mean it won't happen the next time the patient moves or is moved. The patient may just not have hit that exactly right collection of angles/poses to cause a potential injury to become an actual injury.

 

[mikie]

That is what I thought, but the primary crew stood her up and did a standing takedown.

??????

Well not quite the same, but we had a sitting patient with similar complaints, we carefully did a standing takedown, assisting the patient the ENTIRE way, from standing to maintaining a steady posture while we strapped 'em in.

 

[stephenrb81]

KED sounds appropriate from the given scenario but I have seen *many* instances where people just don't want to use the KED, particulary MVC's where rapid extrication wasn't a factor

 

[Ridryder911]

Chances are she is 13 y.o. and has no other outstanding history, I would manually place her on a spine board and C-collar. KED would not be prohibited but on a healthy 13 year old from a 5 feet .. shoulder height...hmmm?

R/r 911

 

[Sasha]

Just a probie EMT but standing take down sounds like too much movement for me, I'd KED her.

 

[mikie]

Yeah, you could, but with enough crew members, it's probably just as easy (just as safe if your careful) and less time consuming (depending on patient condition)

 

[soccrwon]

On my ride along there was a minor car crash involving a stable 60 year old with minor chest pain. They maneuvered her onto a long backboard and then applied a cervical collar. When I asked why they didn't use a KED, the EMT-Basics said the KED was rarely used in field because of the time it took to put on and the fact that few EMTs remember to put in on properly. Correct Procedure, no, but apparently standard unofficial protocol.

 

[BossyCow]

On my ride along there was a minor car crash involving a stable 60 year old with minor chest pain. They maneuvered her onto a long backboard and then applied a cervical collar. When I asked why they didn't use a KED, the EMT-Basics said the KED was rarely used in field because of the time it took to put on and the fact that few EMTs remember to put in on properly. Correct Procedure, no, but apparently standard unofficial protocol.

Wow, so if say, I have EMTs who forget how to do CPR, we can simply eliminate it from the protocols? If you forget to use a tool that is on your rig, that means you need to practice with it, not move it to the back of the cabinet.

 

[Ridryder911]

. They maneuvered her onto a long backboard and then applied a cervical collar. When I asked why they didn't use a KED, the EMT-Basics said the KED was rarely used in field because of the time it took to put on and the fact that few EMTs remember to put in on properly. Correct Procedure, no, but apparently standard unofficial protocol.

Your honor, I rest my case.

R/r 911

 

[mycrofft]

I like that, I have to remember it...unofficial protocol

Sorta like a mental checklist:huh:.

I think it's up to the person on the scene, as long as it's in the protocols, legal, reasonable, and beneficial. This time...absent radiography, toss-up. I'd probably KED her but I'm just into that.

Did I miss anything? I'll get my checklist...

 

[upstateemt]

I don't see that a standing take down would be any more movement that a KED. In a chair with no arms where she could be stabalized from both sides I think it would be less traumatic to stand her straight up and do a standing take down. Providing she did not have any hip or leg pain, standing straight up with assistance and then doing a standing take down from that position would, in my opinion, be less movement than moving her back and forth to apply the KED them pivoting her onto the board.

 

[mikie]

They maneuvered her onto a long backboard and then applied a cervical collar.

Shouldn't the collar have been applied while the patient was in the vehicle (while still maintaining manual stabilization)?

 

[BossyCow]

Shouldn't the collar have been applied while the patient was in the vehicle (while still maintaining manual stabilization)?

Maybe its easier to apply the c-collar when the pt is on that nice stable board?????????:wacko:

 

[reaper]

Shouldn't the collar have been applied while the patient was in the vehicle (while still maintaining manual stabilization)?

Yes, It should have. But, from these post, you can see that nothing is done the way it should be!

 

[Ridryder911]

I don't see that a standing take down would be any more movement that a KED. In a chair with no arms where she could be stabalized from both sides I think it would be less traumatic to stand her straight up and do a standing take down. Providing she did not have any hip or leg pain, standing straight up with assistance and then doing a standing take down from that position would, in my opinion, be less movement than moving her back and forth to apply the KED them pivoting her onto the board.

Ever have back pain? Try standing up and telling me if it hurts? Remember, why you would be immobilizing the patient is probably due to a compression fracture. I do agree, I might attempt this as described below.

Personally have someone hold C-spine and do a modified side by side carry and sit her on the board. Your still providing alignment. In reality, I truly doubt I would really consider a fall of 5' on a ten year old warranting much spinal damage. A thorough assessment may rule out it being a true spinal injury.

R/r 911

 

[mycrofft]

PS: Secret KED additive: Armor-all

okok ten characters...