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EMTCITY EMT CHALLENGE


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KED: used for patients requiring spinal immobilization, often as an extrication aid for people involved in motor vehicle collisions.

First: Apply c-collar to patient and ensure that someone is using manual stabilization throughout this entire process. If in a car, try to lean the seat back away from the seated patient, instructing the patient not to move. Assess CMS on patient's extremities.

Bring KED into the car and place it behind the patient with the head-stabilization portion up and the ischial straps down by the patient's tush. Pull the abdominal/thoracic sections around the patient's midriff, seating firmly under the patient's armpits. Fasten the three straps.

There are two methods I have been taught for these three straps and reassured are correct, and the book seemed to have no preference when I learned, so either fasten MIDDLE, BOTTOM, TOP or TOP, MIDDLE, BOTTOM depending on your local flavor.

Then, maneuver the ischial straps under the patient's thighs, using a see-saw motion to move them as far back towards the patient's butt as possible. Bring the straps up and around from in between the patient's legs, and fasten each to its appropriate clip. Use feed-and-pull to tighten the straps, but try not to pinch anyone's testicles.

Tension the thoracic straps using feed and pull method. Tell women it's about to get a little uncomfortable, but make sure you're not limiting anyone's ability to breathe. Then, using your assistant who has been holding manual stabilization this entire time as help, bring the head-stabilization portion of the KED around the patient's head, having the helper transfer his/her stabilizing force to the outside of the KED until you can get it firmly taped/fastened and the patient's head. Then your patient is ready to be moved to a backboard. Reassess CMS.

Transfer patient to backboard. For the Love of GOD... release the ischial straps.... fasten patient to backboard, and continue with care as necessary.

Next scenario: Describe in detail the initial medical assessment you would do on a suspected Tylenol overdose in a 14 year old patient. You can go ahead and assume the patient is female, conscious, breathing, and the parents have given consent.

Wendy

CO EMT-B

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