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ffemt8978
06-27-2004, 10:36 PM
Another thread got me thinking about this. I had to learn how to apply the KED board during my EMT class, but have never had to use it. I'm not sure that I would even want to use it, since if they need it then they also need rapid extrication. We're required to carry them, but they just collect dust in the back of the ambulance.

I was wondering if any of you have ever used them, and do you like them.

SafetyPro2
06-28-2004, 01:17 AM
Given the choice, I'd use them for any vehicle extrication except a rapid extrication scenario. Seems like most people on the department don't want to use them however.

ffemt8978
06-28-2004, 02:34 AM
Originally posted by SafetyPro@Jun 27 2004, 09:17 PM
Given the choice, I'd use them for any vehicle extrication except a rapid extrication scenario. Seems like most people on the department don't want to use them however.
If you don't mind me asking, why would you choose to use them that often? Personally, I prefer the rapid extrication because there is less movement for the patient involved (no leaning forward, no leg straps) after which you still have to place them on a backboard.

rescuecpt
06-28-2004, 09:58 AM
There's actually less movement with a properly applied KED than a rapid extrication. Rapids are only supposed to be used if the patient is unstable (other than their spine) or if there is some other immediate danger.

KEDs are also very useful in stabilizing a pelvic fracture - turn the KED upside down so that the head portion is on the patient's thigh, and the torso portion is on the patient's hips and torso. Roll the patient onto the open KED, strap them in with the torso straps, and wrap the head piece around their leg, strap that in place as well, and viola, a great splint. :D

JEMs has a more detailed "how-to" on that in one of their old issues.

SafetyPro2
06-28-2004, 10:19 AM
Originally posted by ffemt8978@Jun 27 2004, 11:34 PM
If you don't mind me asking, why would you choose to use them that often? Personally, I prefer the rapid extrication because there is less movement for the patient involved (no leaning forward, no leg straps) after which you still have to place them on a backboard.
Most of the extrications I've been on have involved a lot of twisting and turning to get the patient out (small cars, center consoles, etc.). I think the KED does a better job in immobilizing the patient in that case.

Most of ours are also low speed crashes with minimal trauma, so we're rarely in a situation where rapid extrication is warranted.

ResTech
06-28-2004, 02:20 PM
I agree with Rescuelt. KED boards are only for non-priority patients who still have the potential for neck or back injury. For example, MVC with significant MOI although pt. appears stable with only a complaint of neck pain. I'll admit that I am guilty (as most EMS providers) of "abusing" rapid extrication procedures since I use them on every pt.

Reality speaking I think we immobilize way too much and in many cases cause more discomfort for the patient. It would be so nice to have a spinal clearance protocol.

I do have concerns about getting that one patient that is non-priority and we use rapid extrication and the pt. get's to the hospital and has a significant neck injury with permanent paraylsis. A lawyer would have fun with this since it could be shown that a sub-standard of care was delivered by not applying a KED board and improperly utilizing rapid extrication.

I don't really mind them. It's just one of those things that is forgotten about and get's you weird look's everytime you pull it off the ambulance. Another good use for a KED board is pediatric immobilization.

ffemt8978
06-28-2004, 09:24 PM
Originally posted by ResTech@Jun 28 2004, 10:20 AM
Reality speaking I think we immobilize way too much and in many cases cause more discomfort for the patient. It would be so nice to have a spinal clearance protocol.

I don't know if you've seen my post about our C-Spine precautions, but we have this protocol. Unfortunately, it does NOT allow us to use C-Spine precautions based upon MOI or back pain.

DFDEMS
07-15-2004, 05:19 PM
It works well for peds depending on the size

rescuecpt
07-15-2004, 08:53 PM
We have an adult KED and a peds KED.

Both size KEDs are also part of the protocol for extricating an infant or child from a damaged car seat - except here they are used as a backboard/full body splint to package the patient.

TKO
07-21-2004, 05:00 AM
I was told starting in EMS that KED's were actually used for the purpose of the stock cars. Because of the way these cars are made the KED's are supposedly "made" for its use.

rescuecpt
07-21-2004, 09:35 AM
In theory, a KED should be used anytime there's a suspected spine injury when the patient is not either laying down or standing. That would leave sitting... for example, when I broke my back, I wasn't treated right away. I couldn't stand comfortably and it hurt to lay down, so I sat down... I should have been KED'ed and then put on a backboard.

PArescueEMT
12-24-2004, 11:36 PM
Originally posted by TKO@Jul 21 2004, 05:00 AM
I was told starting in EMS that KED's were actually used for the purpose of the stock cars. Because of the way these cars are made the KED's are supposedly "made" for its use.
I have done NASCAR races. We never use the KED for extrication. A wreck there that a rescue is done on almost always ends up with a rapid extrication, and rapid txpt. I was on the Fire/Rescue crew on the 3 races I did. we only cut 2 times, and neither time was the Pt. stable enough to KED; both were unconscious. If I were on the bus, I would have even called the "grab and run."

I do think they are nice for the civilian low-speed law suit MVC but other than that, I don't think they have much of a use.

In my current setting, I don't have much Pediatric contact, so no comment on the Ped immobilization aspect.

Jon
12-25-2004, 09:46 AM
Originally posted by PArescueEMT+Dec 24 2004, 11:36 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (PArescueEMT @ Dec 24 2004, 11:36 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-TKO@Jul 21 2004, 05:00 AM
I was told starting in EMS that KED's were actually used for the purpose of the stock cars. Because of the way these cars are made the KED's are supposedly "made" for its use.
I have done NASCAR races. We never use the KED for extrication. A wreck there that a rescue is done on almost always ends up with a rapid extrication, and rapid txpt. I was on the Fire/Rescue crew on the 3 races I did. we only cut 2 times, and neither time was the Pt. stable enough to KED; both were unconscious. If I were on the bus, I would have even called the "grab and run."

I do think they are nice for the civilian low-speed law suit MVC but other than that, I don't think they have much of a use.

In my current setting, I don't have much Pediatric contact, so no comment on the Ped immobilization aspect. [/b][/quote]
I've seen and tried the ProLite Speedboard, and am trying to talk my squad into buying one, as we should be using the KED much more than we are, but its A: a pain in the butt, B: you need lots of proctice to be quick, and C: not everyone even knows where it is.

mfkap
12-26-2004, 10:53 PM
I work on a volunteer 911 bus in NY that covers part of the NYS Thruway and another parkway, and we use KED on most MVA's with a stable patient and neck or back pain. We did have a patient about three years ago with a hangman's fracture where we used a KED. The doctor said if we didn't use the KED chances are she would have died or at least been paralized. They are a pain to use, but the concept behind them is that with all your pulling and tugging you are going to do no matter what your method of extrication, the patient's spine won't move during it. I guess if you learn in a system that uses it you don't understand not using it.

On a related note, has anyone used the Speedboard? I have seen them and might switch my agency over to them, just wanted to hear some other people's POV on it.

TTLWHKR
12-27-2004, 04:13 PM
In six years of EMS, I've only used the MediKed twice. Neither for spinal immobilization. Stabilization of a hip fracture...

Jon
12-27-2004, 09:28 PM
Originally posted by mfkap@Dec 26 2004, 10:53 PM
I work on a volunteer 911 bus in NY that covers part of the NYS Thruway and another parkway, and we use KED on most MVA's with a stable patient and neck or back pain. We did have a patient about three years ago with a hangman's fracture where we used a KED. The doctor said if we didn't use the KED chances are she would have died or at least been paralized. They are a pain to use, but the concept behind them is that with all your pulling and tugging you are going to do no matter what your method of extrication, the patient's spine won't move during it. I guess if you learn in a system that uses it you don't understand not using it.

On a related note, has anyone used the Speedboard? I have seen them and might switch my agency over to them, just wanted to hear some other people's POV on it.
Oh, and I'd use them, for EXACTLY that reason, but many a person in both of my squads prefers the stand up and sit down method of spinal immobilization, complete with loose enough straps to fit another patient inside, no problem.

And when we practice, I'll pull out the KED, and the attitude is "we don't use that." Enough of our guys have been through NREMT-P and BETTER know how to use them. KED's shouldn't take lots of time - sure they do, the first 3 million times you use them, and then you can do it as fast with or without a KED - but thats what I like about the speedboard - much faster learning curve, and less obtrusive to Pt. care.

shorthairedpunk
02-12-2005, 02:05 PM
Keds are pretty much regionally liked or dislike it seems, around here, we swear by them and use them quite often, but 20 miles north of us they will cut your throat if you dare pull one out on their scene it seems. Everybody has their reasons for liking or disliking them, it all depends on what yer comfortable using and what you trained on.

emtbuff
02-12-2005, 04:49 PM
This was interesting for me to read through. I have been taught to use the KED during EMT class and haven't seen out since. We usually do a rapid extrication or the patinents are up walking around. As for a hip fracture that is a great Idea usually we scoop our and put them on the backboard.

TTLWHKR
02-12-2005, 06:23 PM
Three times... Just used it again!

Except, not for an MVA. Confined space, it was the only way to immobilize w/ out moving the patient. Got the KED on, lifted the patient, slid the reeves in. Voila! Rescue complete.

Summit
02-13-2005, 05:25 PM
Originally posted by ResTech@Jun 28 2004, 01:20 PM
It would be so nice to have a spinal clearance protocol.
There is a nice wilderness protocol for clearing the spine in the field.

It would be nice to use that.

ffemt8978
02-14-2005, 01:21 AM
Here is a link for a previous thread where I posted our spinal clearance protocols

Protocol Changes, What would you change if you could? (http://www.emtlife.com/index.php?showtopic=137)

I generally try to avoid clearing the spinal column in the field, but will if I have to.

coloradoemt
02-14-2005, 09:36 AM
I have only used a KED once. It was on a multi vehicle MVA. My pt was responsive and complaining of neck and back pain. The first engine was extricating a pt in much worse shape. So while we waited for the second engine to arrive we used the KED. Other than that ours just gathers dust along with most of the ones all of you have.