Question about a call I had

[kyle308]

Well, Saturday night we got toned out to a MVA on the interstate. It was a mustang T-boned by a semi, we arrive on scene and one patient is pinned in the car the other got out and walked to a semi drivers truck and climbed in. The guy in the car we put a C-collar on and just slid in a backboard, once in the ambulance he was complaining of lower back pain and severe abdominal pain, I was wondering if we should of used a KED on the guy.

The man that climbed in the semi was also C-collared and backboarded before loading

Thanks before hand,

Kyle

[akroeze]

Did you manage spinal precautions as effectively without the KED as with it?

If yes, then you didn't need it. However, if precautions would have been improved with the KED, use it.

Like everything we do... do it if it benefits the patient. If it doesn't, why bother?

[kyle308]

well there was a fireman holding C-spine and another at his side so yes all precautions were taken. thanks

[FormerEMSLT297]

Let me just say that IMHO the KED is one of the most UNDERutilized piece of equipment me carry. Having said that, was it indicated in this case.??????

In many states, the KED is indicated unless the patient is critical or unstable and s/he meets the criteria for what is called rapid extrication.

And based on what you said, I can't tell if this patient met the "rapid extrication" criteria.

Some of the rapid extrication signs might be unsecured airway, unconcsious/unresponsive, severe hypotension, etc.

The thing I also try to think about is this. If it's going to take 10 minutes to cut the patient out and you can safely place a KED, why not do it, if the patient is having neck, back etc, pain.

Now if the patient is critical, and you have to "yank" them out quickly so to speak to secure the airway, then do a rapid extrication, and forgo placing the KED, just do it as safely as possible while limiting movement of the back and C- spine.

Former

[Laura Anne]

I don't think anything that was stated proves that the care provided was inadequate. KED or no KED, this person had injuries/complaints of pain that would have had the same results if he was placed on a KED. You took a person from a sitting position in a vehicle to a supine position. Did you pad the voided space under his lumbar region where the pain began post splinting of the body? Have you ever seen a patient with stomach pains IE: Acute AP, kidney stones, cramps? Their abdominal muscles are tightened up in response to the pain so they naturally curl up in a ball to reduce the 'tightness'...rigidity and guarding started after those muscles were expanded via placing person supine. Correct me if I am wrong peoples. Also, like stated above, I feel the KED board is a wonderful tool that isn't used a much as it should, even by myself~ :roll:

Thanks! Hope this helps you out a bit.

[Dustdevil]

Did you manage spinal precautions as effectively without the KED as with it?

The answer to this question is always "no." It cannot be done. Period. And anybody who thinks they can is an idiot. A dangerous idiot.

But yeah... this does go back to the question of whether or not this was a time-critical patient who warranted a rapid extrication or not. If so, you did fine. If not, please ignore the losers you are working with and insist on proper extrication in the future.

Good on you for looking back on your runs and critiquing your performance! That is a very mature and professional thing to do that puts you ahead of many in EMS.

[donedeal]

How did you get a job on a first responder rescue unit at age 15? I thought you had to be 16 to get any job, no matter what it was in this country.

[kyle308]

they lowered the age limit to be a first responder in indiana, and I was doing ride alongs with the service that trained me when we got toned out to this.

[PRPGfirerescuetech]

The answer to this question is always "no." It cannot be done. Period. And anybody who thinks they can is an idiot. A dangerous idiot.

There is nothing in EMS that is this certain. There are always circumstances where one specific tool or treatment while not ideal, might become more effective than the ideal. Your beginning to think inside the box only Dust, dig the sand out of your head.

[Dustdevil]

Okay, perhaps I was not as clear as I meant to be.

I did not mean to say that adequate immobilisation cannot be achieved without a KED. What I meant to say was that it cannot be done manually. It will take some sort of rigid immobilisation device, such as the KED. You absolutely cannot adequately immobilise a patient being extricated with your hands alone. That is chisled in stone. I see no room for intelligent dispute of this fact of simple physics.