A Kendrick extrication device (KED) is a device used in

extrication Vehicle extrication is the process of removing a vehicle from around a person who has been involved in a motor vehicle collision, when conventional means of exit are impossible or inadvisable. A delicate approach is needed to minimize injury to th ...

of victims of traffic collisions from motor vehicles. Commonly carried on

ambulance An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medi ...

s, a KED is typically used by an

emergency medical technician An emergency medical technician (EMT), also known as an ambulance technician, is a health professional that provides emergency medical services. EMTs are most commonly found working in ambulances. In English-speaking countries, paramedics a ...

paramedic A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research. Not all ambulance personnel are p ...

, or another first responder. It was originally designed for extrication of race car drivers. Typically used in conjunction with a

cervical collar A cervical collar, also known as a neck brace, is a medical device used to support and immobilize a person's neck. It is also applied by emergency personnel to those who have had traumatic head or neck injuries, and can be used to treat chronic ...

, a KED is a semi-rigid brace that secures the head, neck and

torso The torso or trunk is an anatomical term for the central part, or the core, of the body of many animals (including humans), from which the head, neck, limbs, tail and other appendages extend. The tetrapod torso — including that of a huma ...

in an anatomically neutral position. Its use is claimed to reduce the possibility of additional injuries to these regions during extrication, although its value has been questioned, as there is a lack of evidence to support its use. The original KED was designed by Richard Kendrick in 1978.

Description

Typically there are two head straps, three torso straps, and two legs straps which are used to adequately secure the KED to the victim. Unlike a long spine board or

litter Litter consists of waste products that have been discarded incorrectly, without consent, at an unsuitable location. Litter can also be used as a verb; to litter means to drop and leave objects, often man-made, such as aluminum cans, paper cups ...

, the KED uses a series of wooden or

polymer A polymer (; Greek '' poly-'', "many" + ''-mer'', "part") is a substance or material consisting of very large molecules called macromolecules, composed of many repeating subunits. Due to their broad spectrum of properties, both synthetic a ...

bars in a

nylon Nylon is a generic designation for a family of synthetic polymers composed of polyamides ( repeating units linked by amide links).The polyamides may be aliphatic or semi-aromatic. Nylon is a silk-like thermoplastic, generally made from pe ...

jacket, allowing the responders to immobilize the neck and upper spine and remove the victim from the vehicle or other confined space. Although a KED can also be used to immobilize infants and children, it is preferable to use specifically designed

pediatric Pediatrics ( also spelled ''paediatrics'' or ''pædiatrics'') is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, paediatrics covers many of their youth until the ...

immobilization devices whenever possible. If a KED is used to immobilize an infant or child, appropriate padding must be used to ensure complete immobilization in a manner that does not obscure the

thorax The thorax or chest is a part of the anatomy of humans, mammals, and other tetrapod animals located between the neck and the abdomen. In insects, crustaceans, and the extinct trilobites, the thorax is one of the three main divisions of the cre ...

and

abdomen The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the to ...

, thereby preventing continued assessment of these vital areas.

Application

The device can be quickly and easily inserted into the seat of a vehicle by a single

rescuer A rescuer is a person who rescues something from harm or danger. They are trained in some combination of technical rescue, diver rescue, mountain rescue, extrication rescue, and advanced firefighting. The term is commonly used with people who ...

, allows access to the

airway The respiratory tract is the subdivision of the respiratory system involved with the process of respiration in mammals. The respiratory tract is lined with respiratory epithelium as respiratory mucosa. Air is breathed in through the nose to ...

and conforms to any body size. A KED is typically used only on hemodynamically stable victims; unstable victims are extricated using rapid extrication techniques without the prior application of the KED. Once the KED is slid into position, it is secured to the victim with straps in order to prevent movement. The first strap that is secured is the middle torso strap. According to the KED users' manual securing this strap secures the greatest area of the device and therefore provides the greatest stability while securing the rest of the device. Next the bottom torso strap is secured, however the top torso strap is not secured until just prior to moving the patient to the long spine board. This is to allow the patient to breathe easily while the rest of the device is secured. Following the bottom torso strap the leg straps are secured. These may be applied in a "criss-cross" fashion (according to the KED users' manual this is the most commonly used method), or applied by securing them to their respective sides. If there is any evidence of a groin injury the "criss-cross" method cannot be used. Following application of the leg straps the void between the head and device is padded as needed and the head is secured. Finally, just prior to moving the patient to a long spine board the top strap is secured. Some schools teach this order by remembering the phrase "My Baby Looks Hot Tonight" or "Maori Boys Love Hairy Teke", where the beginning of each word stands for Middle torso strap, Bottom torso strap, Leg straps, Head strap and Top torso strap. The head pad can bring the head too far forward for the side panels to fully immobilize it. Care must be taken to secure the head properly to maintain neutral immobilization. If the head is too far forward, the head is brought back to meet the KED unless crepitus, pain or resistance is met. If these symptoms are present, the head is immobilized in the position found. There has been debate surrounding the exact order of applying the torso straps, with some saying that the order does not matter as long as the torso is secured before the head. The KED users' manual is sometimes used in these debates: it states the reason the top strap is last is a function of breathing and not the process of immobilization itself.KED User's Manual
2001, p. 11

Value

There is controversy about whether the use of a KED is actually appropriate in prehospital care. A 2015 article in the '' Journal of Paramedic Practice'' said that although the device has been used since the 1970s, its "overall appropriateness in patient care should be viewed with caution" and there is a "lack of evidence to support its use". A 1988 article in the ''

Canadian Medical Association Journal The ''Canadian Medical Association Journal'' (French ''Journal de l'Association Médicale Canadienne'') is a peer-reviewed general medical journal published by the Canadian Medical Association (CMA). It publishes original clinical research, anal ...

'' said the device had "yet to be evaluated for its immobilization of the cervical spine" and that "the role and performance of the device in transferring patients by road or air ... must be addressed".

Rapid extrication without a KED

During rapid extrication, the patient is not immobilized by a KED, but rather taken directly out of the car onto a back board. Reasons for using this technique include: *The scene is unsafe *The patient's condition is unstable *The patient is blocking access to another victim.

References

{{Emergency medical services Emergency medical equipment Medical transport devices Rescue equipment