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EMS Patient Handling Tips



The Ambulance Driver's Perspective
by Kelly Grayson

The upside-down KED


Name: Kelly Grayson


Kendrick Extrication Device

She's a sweet little old lady who has fallen and can't get up. The reason she can't get up is obvious; a shortened and internally rotated left leg. Complicating matters, she has had the misfortune of falling in a cramped bathroom, between the tub and the toilet.

Normally, you'd grab your handy scoop stretcher and handle your business, or if this were in a nursing home, you'd choke back the pointless lecture on not moving injured patients, do a gentle sheet transfer from her bed to your cot, and thank the nurse for all her, ummm… help.

Neither of those techniques will work for your patient, so what do you do when you must package that hip fracture in tight confines?

Easy, just grab your Kendrick Extrication Device.

Now, I'm pretty sure this trick doesn't appear in any of Ferno's training literature on the KED, but I did mention the technique to Rick Kendrick over beers at an EMS conference once, and he chuckled.

Hey, that's as good as official approval in my book.

Now, many of you seasoned medics have heard of or used some variation of this trick, but most of the newbies haven't. All you do is flip your KED upside down and apply it that way. Doesn't matter if they're lying on their side or supine, you can make it fit, and it makes a dandy improvised pelvic binder.

Picture your patient lying on the floor. You've already started an IV and given her a dose of rapid-acting analgesic (You do give analgesics before you do something as painful as splinting a hip, right?), and you're ready to position the KED. In a coordinated move with your partner, slide the upside-down KED under her hips until the bottom edge of the device is positioned over her lower back, say about 3 inches above her iliac crests.

Take your handy dandy head padding supplied with the device and pad her injured hip with that. Add additional padding between her legs, and tighten the torso straps around her hips and upper thighs. Now take those head flaps, and wrap them around her calves, and strap them in place with the head straps.

Voila! Now you have her hip splinted, and you have two handy carrying straps to left her by. Simply grab those straps, use your other hand to clasp your partner's under the lady's legs, and carefully move her onto the stretcher. Don't forget to check distal sensory, motor and circulatory function in her feet, just like you'd do after any splinting maneuver.

You can either leave her splinted as-is for the transport, or position your scoop stretcher on your cot before gently lowering her onto it. I've found that the technique works so well to splint and move the patient that the scoop stretcher is usually unnecessary.

Give this trick a try next time you have to splint a hip fracture in cramped quarters, and let me know how it works out for you and your patient!


About the author


Kelly Grayson, NREMT-P, CCEMT-P, is a critical care paramedic in Louisiana. He has spent the past 18 years as a field paramedic, critical care transport paramedic, field supervisor and educator. He is a former president of the Louisiana EMS Instructor Society and board member of the LA Association of Nationally Registered EMTs.

He is a frequent EMS conference speaker and contributor to various EMS training texts, and is the author of the popular blog A Day In the Life of an Ambulance Driver. The paperback version of Kelly's book is available at booksellers nationwide. You can follow him on Twitter (@AmboDriver) or Facebook (www.facebook.com/theambulancedriverfiles), or email him at kelly.grayson@ems1.com.

Comments
The comments below are member-generated and do not necessarily reflect the opinions of EMS1.com or its staff. If you cannot see comments, try disabling privacy and ad blocking plugins in your browser. All comments must comply with our Member Commenting Policy.
Kyle Andreasen Kyle Andreasen Friday, December 09, 2011 8:46:23 AM Awesome tip Kelly! How about a video to help visualize!
Monday, January 23, 2012 1:59:51 AM Yes, please! A good video on this will be a great help. This is very interesting! Pleeeeeaaasssee!
David Krueger David Krueger Sunday, January 29, 2012 6:30:39 PM been using this method for years, works very well.
Linda Walker Linda Walker Tuesday, February 14, 2012 6:02:07 PM used a ked upside down more than right side up in the over 20 yrs of ems under my belt. works wonders.
Meri Kassner-Gomez Meri Kassner-Gomez Sunday, May 13, 2012 8:09:50 AM I have used a KED for hip splinting several time in the last 13 years. Works like a charm! I was actually explaining this technique to a new EMT just the other day. Sometimes we have to be a little creative!
Trevor Bland Trevor Bland Thursday, August 23, 2012 6:06:55 PM Excellent splint option. Have used it for years.
Jeffrey A Zero Jeffrey A Zero Wednesday, December 11, 2013 11:58:12 AM would like to see photos of this