Kendrick Extrication Device

[Happiness]

I will always love this equipment as I have said many times. I use it when it is warrented and I have never used it on anyone that is NOT stable. I have used it for the following.

Guy who fell off roof and landed on feet. He crawled to his car and go to the hospital parking lot and couldnt get out.

2month old baby that fell off of change table.

Heavy equipment operator that fell off of log sorter, foot got caught in something and dislocated hip. Used to get him out of the heli and onto a board.

Head on collison (under 20 clicks)girl walked to the ambulance sat in the captains chair before I could say stop and then said my neck hurts. Other pt was stuck in car with a broken ankle.

There are a few more but you have to use commen sense in any piece of equipment and if it is not going to be benifical for the pt then dont use it.

I think what happens in our training is that we are told when to use and when not to use in call`s but forget to think outside of the box. I dont use anything else but a pillow and zap straps for broken ankles, was never trained in it but it is the best thing I have found.

[HERBIE1]

In my case, by far, the most common use for a KED has been to immobilize small children- usually for trauma, but sometimes simply to be able to examine and/or treat a very squirmy kid. It works great, and I started doing this years ago after using the "Papoose" while working in an ER and realizing I could apply this concept in the field. A KED was far easier and more effective than trying to secure a kid directly to a long board. Of the thousands of MVA's I have had, I can recall using a KED exactly one time-long extrication, fairly stable patient- basically just for fun.

One other use- a guy who fell into an elevator pit. He had motor and neuro deficits, and I literally had to fight the knucklehead rescue guys to slow down so I could stabilize him before we pulled him out. The chief was NOT happy with me until I later demonstrated by exam that this poor guy had no feeling below his ribs. Dangling over him, about 8 feet down, putting on the collar and KED alone(simply no room for anyone else) took awhile, but there was no other option. I then let the rescue guys hook up a harness to pull him out vertically.

I think like anything, ,many times you adapt your tools to suit your purposes. Is the KED a vital piece of equipment- no- there are other ways to accomplish your goal.

Can it be useful? Absolutely and they certainly do not take up much room on the rig.

To doc's point about EVIDENCE that is does what it's designed to do.-that's another story. Like spinal immobilization, I think in 99.9% of the cases, it is completely unnecessary. I have NEVER seen a cervical fracture in a patient that I did not suspect one. The only cervical injuries I have seen have been multiple injuries with high speed trauma- pedestrians vs cars, motorcycles, etc.

One exception to that- a freak occurrence. A 6o year old man who tripped and fell onto concrete while jogging. Laceration to his forehead- nothing more. No LOC, no other injuries, no deficits, healthy and stable with no medical history. He didn't even want to be transported- he wanted a bandage and to finish his run. Something told me to immobilize the guy, and thank gawd we did: Sublexed C-5. It happens, but can we- or should we be able to- foresee any possible outcome? No, because in that case, we should be doing 12 lead EKG's and full work ups on every patient to catch the one in a "million" undiagnosed congenital arrhythmia someone may have.

I know some places can clinically clear a c-spine in the field, but it is rare. I understand the POTENTIAL outcome from a missed spinal cord injury, but again- they are rare and with training and solid protocols, that danger can be mitigated.

Evidence based medicine. Time for the EMS community- and more importantly, the powers that be- to truly embrace it.

[CBEMT]

Head on collison (under 20 clicks)girl walked to the ambulance sat in the captains chair before I could say stop and then said my neck hurts. Other pt was stuck in car with a broken ankle.

You KEDed her... INSIDE the ambulance? Jeez. She walked that far, put a collar on, throw the board on the stretcher, and have her lay down. KISS.

[Richard B the EMT]

Happiness, re the patient who you KEDed in the ambulance, I must presume, on your paperwork you followed the mantra:

Document, DOCUMENT, DOCUMENT !

[Happiness]

You KEDed her... INSIDE the ambulance? Jeez. She walked that far, put a collar on, throw the board on the stretcher, and have her lay down. KISS.

So really if you look at my EXAMPLES in the wrong perpective. They were examples of my uses with the KED. I didnt go into detail with any of my examples. Dont assume I didnt follow my protocols and not have a hard collar on. Dont assume that she walked a mile to get to the ambulance as a matter of fact it was a few steps and she got in the side door before I could do anything.... Jeez.

Happiness, re the patient who you KEDed in the ambulance, I must presume, on your paperwork you followed the mantra:

Quote

Document, DOCUMENT, DOCUMENT !

I am very good at doumentaion of my calls. I dot the i's and cross the tees.

[tniuqs]

Happiness, re the patient who you KEDed in the ambulance, I must presume, on your paperwork you followed the mantra:

Richard we up here have a different system of Law and far less pointing fingers for Ca$H only... one has to prove damages and that is not easy thing to do, far more latitude than strict following of protocols.

I would hazard a guess per call compared to the US is 1 to 1000 in EMS legal issues that go anywhere.

cheers

Edited November 19, 2010 by tniuqs