Re: Value of KED (was Re: Extrication practice???)

Carey Gregory wrote:

> Thanks,  Mark, but do you have titles or author names?  Drilling down from
> PubMed to find articles based only on journal names and dates is a really
> difficult process.  And search words like KED, K.E.D, and Kendrix produce
> nothing at all.
>  
Oops, sorry.  Here.  They give positive conclusions but don't look that 
promising.  I mean the "Ns" are small and it looks like the situations 
are simulated.  They're all I could find via PubMed.  So I'm not 
convinced either; it's not compelling anyway.
--
Mark

Ann Emerg Med. 1989 Sep;18(9):943-6.


A practical radiographic comparison of short board technique and 
Kendrick Extrication Device.

Howell JM, Burrow R, Dumontier C, Hillyard A.

Wilford Hall USAF Medical Center, Lackland Air Force Base, Texas.

Cervical spine immobilization is necessary during the prehospital care 
of most trauma patients. Earlier studies performed in controlled, indoor 
settings suggested short board technique (SBT) was the standard against 
which other methods of cervical stabilization should be measured. Our 
study approximated the prehospital setting by comparing the use of tape, 
SBT, and Philadelphia collar (PC) with tape, the Kendrick Extrication 
Device (KED), and PC after immobilization in and extrication from a 
compact car. Seven men were immobilized with KED and SBT in addition to 
PCs and tape. These subjects were extricated and then taken by ambulance 
stretcher across a 50-yd length of concrete to the radiology suite. 
Flexion, extension, lateral bending, and rotation were measured. KED-PC 
(16 degrees +/- 8 degrees) was statistically superior to SBT-PC (41 
degrees +/- 5 degrees) in limiting rotation (P less than .001). KED-PC 
and SBT-PC were similar in their abilities to limit extension (8 degrees 
+/- 4 degrees vs 6 degrees +/- 5 degrees), flexion (4 degrees +/- 2 
degrees vs 4 degrees +/- 4 degrees), and lateral bending (13 degrees +/- 
5 degrees vs 17 degrees +/- 6 degrees). In an approximation of the 
prehospital setting, tape, a PC, and either KED or SBT substantially 
limit extension, flexion, and lateral bending of the normal cervical 
spine. KED-PC is more beneficial in rotation.

Ann Emerg Med. 1987 Oct;16(10):1127-31.


A radiographic comparison of prehospital cervical immobilization methods.

Graziano AF, Scheidel EA, Cline JR, Baer LJ.

Department of Emergency Medicine, Butterworth Hospital, Grand Rapids, 
Michigan.

Three methods of prehospital cervical immobilization were studied 
radiographically and compared to the short board technique (SBT). The 
methods were California Stif-Neck Immobilizing Collar (CSC), Kendrick 
Extrication Device (KED), and Extrication Plus-One (XP-One). Forty-five 
volunteers were immobilized in the short board (SB) and one of the test 
devices studied. Cervical movement in the sagittal and frontal planes 
was measured radiographically. Movement in the horizontal plane was 
measured directly. Two-tailed, paired t test analysis was performed 
comparing test devices to the SBT. The SBT proved to be significantly 
better (P less than .05) in the following comparisons: the CSC in 
extension and lateral bending; the KED in lateral bending; and the 
XP-One in extension. We confirm the SBT as the standard of comparison 
against which newer prehospital devices can be compared objectively. Of 
the three devices compared against the SBT, the factory-fabricated short 
board devices (KED and XP-One) provided the greatest degree of 
immobilization, in addition to logistical advantages over the SBT.

Prehosp Emerg Care. 1999 Jan-Mar;3(1):66-9.


The Kendrick extrication device used for pediatric spinal immobilization.

Markenson D, Foltin G, Tunik M, Cooper A, Giordano L, Fitton A, Lanotte T.

Department of Pediatrics, New York University School of Medicine and 
Bellevue Hospital Center, New York 10016, USA. [EMAIL PROTECTED]

Immobilizing a child presents a unique challenge for emergency medical 
services (EMS) personnel in addition to those challenges faced when 
immobilizing an adult. Most equipment commonly carried by EMS personnel 
is sized for adult use and as a result does not routinely provide 
adequate static or dynamic immobilization of a child. In addition, 
children often resist immobilization and can free themselves from 
standard strapping techniques. These problems have led to the 
modification of existing equipment and the development of several 
pediatric-specific devices. An ideal pediatric immobilization device 
would be one that uses an existing piece of equipment, is of limited 
additional cost, is routinely used by EMS providers, could be easily 
modified to immobilize a child, could easily be taught to EMS providers, 
and provides excellent static and dynamic immobilization. The Kendrick 
extrication device (KED) used as the authors describe meets these goals 
of an ideal pediatric immobilization device.