What is a KED (Kendrick Extraction Device) medical device?

KED is a Spinal Immobilization Device, Not a Medical Test

The Kendrick Extrication Device (KED) is not a medical test—it is a semi-rigid spinal immobilization device used by emergency medical services (EMS) personnel to stabilize and extricate trauma patients with suspected spinal injuries from confined spaces, particularly motor vehicle collisions. 1

Device Description and Purpose

The KED is a vest-like immobilization device designed to stabilize the head, neck, and torso of trauma patients during extrication from vehicles or other confined spaces. 1, 2 It consists of a semi-rigid structure that maintains firm support of the cervical spine and thoracic region while allowing vertical or seated extrication when horizontal stabilization is not feasible. 2

Clinical Applications

Primary Use in Motor Vehicle Collisions

• The KED is primarily used to extricate patients from motor vehicles when spinal injury is suspected. 1, 3
• It provides superior rotational control compared to short board technique, limiting rotation to 16° ± 8° versus 41° ± 5° with short board technique (P < 0.001). 1
• Both methods provide similar limitation of extension (8° ± 4° vs 6° ± 5°), flexion (4° ± 2° vs 4° ± 4°), and lateral bending (13° ± 5° vs 17° ± 6°). 1

Specialized Rescue Scenarios

• The International Commission for Mountain Emergency Medicine supports KED use in narrow crevasses when horizontal evacuation is impossible. 2
• The device allows vertical stabilization when space constraints prevent horizontal stretcher placement. 2

Pediatric Applications

• The KED can be modified for pediatric spinal immobilization, providing an advantage over adult-sized equipment that often fails to adequately immobilize children. 4
• Children frequently resist standard immobilization techniques, and the KED's design helps prevent self-extrication. 4

Comparison with Rapid Extrication Method

Neurological Outcomes

• A retrospective study of 81 motor vehicle collision patients with vertebral column injuries found no differences in pre- and post-extrication neurological outcomes between KED (53.1% of patients) and rapid extrication method (46.9% of patients). 3
• No changes in motor function or sensation to extremities occurred with either method. 3

Time and Movement Trade-offs

• Rapid extrication is significantly faster than KED application. 5
• However, rapid extrication produces significantly larger angles of head turning compared to KED use. 5
• Patient weight marginally modifies KED effectiveness, with obese patients showing increased movement when using KED (p = 0.029 for angle to right after backboard transfer; p = 0.011 for subjective movement). 5
• No statistical differences exist in patient discomfort or pain between methods. 5

Clinical Decision-Making

Use the KED when:

• The patient is seated in a confined space (vehicle, crevasse) with suspected spinal injury 1, 2
• Time permits proper application without compromising patient stability 3
• Rotational control is particularly important 1
• The patient is pediatric and standard equipment is inadequate 4

Consider rapid extrication instead when:

• The scene is unsafe and immediate removal is necessary 3
• The patient is critically unstable and time is critical 5
• The patient is significantly obese (though evidence is limited) 5

Common Pitfalls

• Do not confuse the KED with a diagnostic test—it is purely a stabilization and extrication device. 1, 2
• Do not assume the KED prevents all spinal movement—it significantly reduces but does not eliminate cervical motion. 1
• Do not use the KED as a substitute for definitive spinal imaging and evaluation once the patient reaches the hospital. 3