KED and pregnancy...

[brentoli]

I agree with ambo driver, once you lay her on her side, you have lost all spinal immobilization, so why bother

Really? Hmmm, guess I need to go back to the class two weeks ago and tell my students I was wrong.

[DwayneEMTP]

Really? Hmmm, guess I need to go back to the class two weeks ago and tell my students I was wrong.

Actually, they do have a point. It's been proved and proved that we offer almost no spinal care with a collar and L/B, so if we take almost none and turn it on it's side, maybe we have lost the little that we gained...not sure, but intuitively it makes sense..

So yeah, you may want to go and fess up to your class brother...scientifically speaking you led them off into the ditch... :-)

Dwayne

[Happiness]

Actually, they do have a point. It's been proved and proved that we offer almost no spinal care with a collar and L/B, so if we take almost none and turn it on it's side, maybe we have lost the little that we gained...not sure, but intuitively it makes sense..

So yeah, you may want to go and fess up to your class brother...scientifically speaking you led them off into the ditch... :-)

Dwayne

I have to disagree. I still think the theroy of the full spinal is good, you cant say that by not stopping all movement of the pt is of no benefit. So I will give an example.

MVA pt goes to hospital, medics have pt packaged in full spinal. X-ray tech by direction of Dr. finished x-rays and removed the collor took all the straps off etc. Then they sit the pt up and with a scream the pt fell back and is now a parapaligic for the nipple line down. He had no neck pain, back pain, numbness or tingling. Now this might be a once in lifetime thing but it is what it is. It turned out the the T3 was fractured and with the movement completely severed the cord.

Im sure that there is good research for both sides but I still feel better doing the spinal. Also if you do them properly and with alot of care you can do a good spinal with the pt on their side.

With the KED (my favorite peice of equipment) I would use it on a pregnant woman who might be about 6 months but I'm not sure if I would in a later pregnancy. But who knows.

[brentoli]

Actually, they do have a point. It's been proved and proved that we offer almost no spinal care with a collar and L/B, so if we take almost none and turn it on it's side, maybe we have lost the little that we gained...not sure, but intuitively it makes sense..

So yeah, you may want to go and fess up to your class brother...scientifically speaking you led them off into the ditch... :-)

Dwayne

I think I read it wrong the first time, reading your reply. I was picturing hiking the side of a backboad up with a supine pt strapped in. Sounds like you guys were picturing someone lying on their side strapped to the board?

[ambodriver]

Sensitive, sensitive! Think I care about some negative points on my profile here? Sorry, not in it to win a popularity contest. Bite me.

back on to topic.....................

I've used to KED ONCE. Our local trauma center called our firehouse to goto a church for a pastor that was released earlier in the day. They said he had a cervical fx. s/p fall that they missed on the X-Ray. He was sitting up and as a super precaution we used the KED to immobilized him and move to a backboard.

I see the KED as a waste of time. You can accomplish the task far easier and less whippish if you apply a c-collar, hold manual stabilzation and jam a backboard into the car and guide the patient down. Fumbling around with that KED how much are you twisting, and moving that patient around. Proper handling of the pt. will work much better in this situation.

The real problem, is the ridic. notion in EMS that everyone in any sort of fall/MVC must be backboarded. How about allowing a more thorough exam and letting us clear C-Spine in the field instead of these ridic. backboards, that quite frankly probably do more harm then good in a cervical injury.

p.s. i've heard the KED is good for immobilizing little kids. We have a seperate device for that, and again it does more harm then good to wrestle a kid into those things, don't ya think?

earth to common sense?

Edited August 6, 2011 by ambodriver

[BushyFromOz]

I see the KED as a waste of time. You can accomplish the task far easier and less whippish if you apply a c-collar, hold manual stabilzation and jam a backboard into the car and guide the patient down. Fumbling around with that KED how much are you twisting, and moving that patient around. Proper handling of the pt. will work much better in this situation.

And there, you self centered egotistical bullshit show you for what you really are. You cant be bothered using a piece of equipment because its to difficult for you

If your "whipping" the patient, fumbling, twisting and moving them to get it on you either havn't assessed weather the scene enables you to apply it effectively, or you just dont know how to aply it properly.

When applicable and used properly by a competent person, the KED IS part of the proper patient handling.

Your just a moron mate, who's own lazyness supercede those of a patient, and you show it time and time again. The old rep system would have shown how many people have taken exception to the benality of your posts

How about allowing a more thorough exam and letting us clear C-Spine

So you've just pointed out that using one piece of equipment is too damn hard, but at the same time want whoever "the man" is to let you clear c-spines in the field? Why should they let you, your too lazy to do a proper job now.

[Timmy]

I guess the down side coming from a nursing background is we don’t get to play with all this fancy equipment, needless to say I haven’t had any training on the application or use of a KED but I have seen it used a hand full of times.

After consulting a book I have called “A photographic guide to prehospital spinal care” written by a man called Anthony Hann and reviewing an article written by various people from the Department of General Medicine at the Toronto Hospital in regards to extraction and immobilisation of spinal injuries there appears to be very little literature provided on this very subject, in fact I have struggled to find anything to suggesting pregnancy is a contraindication. The article did briefly mention the use of KED during pregnancy but it wasn’t strongly supported and certainly didn’t go into great depth.

I guess it comes down to the providers knowledge and assessment of the situation and patient as to when to apply such an immobilisation device, like they always say, everything in moderation

– if you don’t pull the straps to tight around the chest/abdominal region then I guess there isn’t a strong potential for things going pear shaped.

Edited August 6, 2011 by Timmy

[ambodriver]

And there, you self centered egotistical bullshit show you for what you really are. You cant be bothered using a piece of equipment because its to difficult for you

If your "whipping" the patient, fumbling, twisting and moving them to get it on you either havn't assessed weather the scene enables you to apply it effectively, or you just dont know how to aply it properly.

When applicable and used properly by a competent person, the KED IS part of the proper patient handling.

Your just a moron mate, who's own lazyness supercede those of a patient, and you show it time and time again. The old rep system would have shown how many people have taken exception to the benality of your posts

So you've just pointed out that using one piece of equipment is too damn hard, but at the same time want whoever "the man" is to let you clear c-spines in the field? Why should they let you, your too lazy to do a proper job now.

whoa whoa super medic. Let's not take this into a personal attack because you don't like my opinion of the KED? Use it if you like it, I could really give two shits what ya use or how ya use it. Truth is, you

have no idea how I operate, who I am, or what I think is important.

Funny...I'm on a 48er and just came back from some BS MVC. We threw the collar on him, put the board under his butt halfway on the cot and had someone behind him guide him down onto the backboard. Was lovely and went smooth. The guys complaint was "shoulder pain" near the seatbelt area. No damage to the car whatsoever. I wouldn't have even backboarded him after a more thorough back exam, but its so ingrained in these parts that its almost taboo to suggest anything against it.

Throwing the KED on this guy would have required much more pt. movement then simply c-collaring him and moving him to the backboard from inside the car, or even /gasp letting him self extricate, stand, then sit onto the backboard to be guided down. Don't take it from me though, you clearly know-it-all and will get pissy if I voice my opinion.

The KED might be nice if the only way to get him out was from above, lets say if we cut the roof off.

Don't take it from me though. I'm just a lazy incompetent ambulance driver who doesn't know how to use a ked

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2691505/

http://ukpmc.ac.uk/abstract/MED/9523928/reload=0;jsessionid=4CB35A3D4ADDBC204DDF09C8D6A1AD34

[Happiness]

Sensitive, sensitive! Think I care about some negative points on my profile here? Sorry, not in it to win a popularity contest. Bite me.

back on to topic.....................

I've used to KED ONCE. Our local trauma center called our firehouse to goto a church for a pastor that was released earlier in the day. They said he had a cervical fx. s/p fall that they missed on the X-Ray. He was sitting up and as a super precaution we used the KED to immobilized him and move to a backboard.

I see the KED as a waste of time. You can accomplish the task far easier and less whippish if you apply a c-collar, hold manual stabilzation and jam a backboard into the car and guide the patient down. Fumbling around with that KED how much are you twisting, and moving that patient around. Proper handling of the pt. will work much better in this situation. So first you still use a collar, you still manual stabilize, and by jamming a ked down the pts back and then tighening the straps you have less movement of the spine as your placeing the pt on the board. You can use both. Now keep in mind this piece of equipment is for stable pts only. So if your pt is critical your not useing the KED in the first place.

The real problem, is the ridic. notion in EMS that everyone in any sort of fall/MVC must be backboarded. How about allowing a more thorough exam and letting us clear C-Spine in the field (you cant clear C-spine in the field?) instead of these ridic. backboards,(cant you use a scoop or clam shell instead of a back board?) that quite frankly probably do more harm then good in a cervical injury.

p.s. i've heard the KED is good for immobilizing little kids. It is awsome for immobilizing little kids and babies.

earth to common sense?

[ERDoc]

http://www.ncbi.nlm....les/PMC2691505/

http://ukpmc.ac.uk/a...DDF09C8D6A1AD34

+1 for providing an evidence based arguement