The Kendrick Extraction Device

The Kendrick Extraction Device
(KED)

What is it?

A device to enable total spinal immobilisation during extrication

Designed to enclose the torso and cervical spine in a rigid frame therefore eliminating flexing, extension and rotation of the spine during movement of the casualty

KED Construction

The carcass of the KED is made of a flexible material.

Reinforced with wooden slats to prevent deformation once applied.

Has a head piece which, in combination with a hard cervical collar, eliminates movement of the cervical spine

Has 3 straps, with corresponding buckles, that wrap around the torso to fix it in position.

Has 2 straps that secure it at the groin.

Has a malleable cushion to place behind the head.

Has head and chin straps to secure the head within the device.

Has carrying/lifting handles on both sides.

Before application of the KED

Before the KED is applied, the crash helmet must be removed in the approved manner maintaining manual in-line stabilisation.

If a HANS device is in use, the helmet must first be separated from the shoulder section.

A properly fitting hard cervical collar must then be applied. If a HANS device is in use the shoulder section must first be removed.

Manual in- line stabilisation of the cervical spine should be maintained throughout application of the KED even though a collar has been applied.

If there is inadequate space for helmet removal or KED application, space must be created.

This may necessitate removal of a roof or roll cage.

It may be possible to lower the driver in the seat to allow helmet removal/KED application.

Wings on seats severely hamper KED application and should be cut away if necessary. (A helmet saw is ideal for this task).

Teamwork

Successful use of the KED requires teamwork and training.

Each member of the team must be designated a specific tasks to be carried out in a specific order.

The ideal team - 5 trained crew &
1 doctor/paramedic. (according to the FIA)

The role of the Doctor

To make the decision - KED or no KED
- spinal injury?
- other injuries?
- how much time have we got?

Initial helmet removal and cervical collar application

Continuous casualty monitoring

Communication with the casualty

Check security of KED before extrication begins

Control of the head during extrication

Role of the Team Leader

Liase with doctor.

Radio communications.

Deciding how to create space if necessary and arranging the use of a rescue unit should any cutting be required.

Monitoring/supervising the application of the KED and extrication of the casualty.

Not to get directly involved in KED application unless absolutely necessary.

Role of crew member 2

Assist doctor with helmet removal and application of cervical collar.

Maintain in-line manual stabilisation of cervical spine during KED application.

Role of crew members 3 & 4

Prepare equipment whilst helmet is being removed and cervical collar applied.

Application of the KED.

Extrication of the casualty under the control of the Doctor, assisted by other
Crew Members and under the supervision of the Team Leader.

Role of crew member 5

Driver

Equipment preparation

Extrication of the casualty under the control of the Doctor and assisted by other
Crew Members and supervised by the Team Leader.

Application of the KED

1) Slide KED between casualty and seat. This will require easing the casualty forward temporarily whilst maintaining cervical spine control.

2) Check that KED is correctly aligned and that wings are fitting correctly under arm-pits and around torso

3) Ease casualty back in the seat onto the KED.

Only one movement foreword and back must be employed to minimise the risk of damaging an unsupported spin

4) Apply straps in the following order if using the FIA protocol;
1st - Torso middle

2nd - Head (after insertion of head
roll)

3rd - Chin

4th - Torso bottom

5th - Crutch

6th - Torso top

5) Re-check and tighten all torso straps and groin straps.

6) Re-check and adjust head and chin straps if necessary. Secure limbs.

7) Lift casualty clear of wreckage, under the control of the Doctor, and onto a spine board or vac-mat as appropriate.

8) Loosen groin straps and lie the casualty horizontally as soon as possible.

9) Transfer casualty, on the spine board or vac-mat onto the ambulance cot and then into the rescue unit or ambulance.

10) If a long journey is expected, transfer the casualty from the long spine board onto a vac-mat using the bridge manoeuvre.

KED pitfalls

No one talks to the casualty

HANS, Belts and Steering Wheels

Should be removed after you have manually stabilised the C-spine but before you remove the helmet

Insufficient space

Cut seat wings off

Ease casualty down the seat

Bring casualty forward to prevent helmet fouling on head restraints

Cut the roof off

Cervical Collar

Wrong size - Offer Doctor a selection

Insecure - Ensure contact with flesh

Velcro sticks to seat or won’t fasten

Casualty Movement

All movements must be in line with no twisting before the KED is secure

Move the casualty down the seat to provide space for helmet removal

Tilt the casualty forward to allow the KED to be inserted

Don’t move the casualty again until they are secure in the KED

KED Alignment

The casualty and the KED must be vertical, not leaning at an angle

The KED must be tight up under the casualty’s armpits

The Lifting Handles are there to assist in this process

KED Fastening Strips

Attach to seat material

Head Roll

The Roll is intended to fill the gap between the casualty’s head and the KED

Just because it can be trebled in thickness using the Velcro securing strap DOESN’T MEAN YOU HAVE TO DO IT!

Smaller pillows can be used and may be better

Forehead and Chinstraps

Get lost and Velcro gets worn - Always carry spares

Must be applied on either side simultaneously - forehead strap first.

Crutch Straps

Buckles flip up or are difficult to locate - Tape or sew to KED

Difficult to tighten sufficiently - "Saw" under buttocks to get in correct position.

Long Board

Requires extra muscle and takes up extra space. Often more of a hassle than being useful

Must be secure and flat from side to side even if it is raked top to bottom.

Must be removed (from the foot end) using the Bridge Manoeuvre when placing the casualty on a Vac Mat

If not used ensure the casualty is supported flat as soon as possible by lifting their buttocks

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