What is a KED and Why EMS Professionals Need to Know
KED EMS refers to the use of the Kendrick Extrication Device in Emergency Medical Services. This essential tool helps safely remove patients from confined spaces while maintaining spinal immobilization.
Quick KED Facts:
- Purpose: Immobilizes head, neck, and torso during extrication
- Invented: 1978 by Richard Kendrick (patented 1980)
- Construction: Semi-rigid vest with wooden/polymer slats in nylon jacket
- Weight: Approximately 7.3-8 lbs (3.3-3.6 kg)
- Patient capacity: Up to 550 lbs (249.5 kg)
- Application time: Average 6.63 minutes (significantly longer than rapid extrication)
The Kendrick Extrication Device (KED) is a crucial piece of equipment that has been a staple in emergency medical services for decades. Originally designed to safely remove injured race car drivers from their vehicles, this semi-rigid brace has evolved to become standard equipment on ambulances nationwide. The KED works by securing a patient's head, neck, and torso in a neutral position, minimizing movement during the critical extrication process.
When used correctly, the KED helps prevent secondary spinal injuries that could occur during patient removal from confined spaces like vehicle wrecks. Studies show that 3% to 25% of spinal cord injuries actually happen after the initial trauma, either during transit or early management—highlighting why proper immobilization techniques are essential.
However, the KED isn't appropriate for every scenario. In situations requiring rapid extrication (like unstable patients or hazardous scenes), the extended application time of over 6 minutes may be detrimental compared to faster techniques.
I'm Mortuary Cooler, a national-level mortuary cooler supplier with extensive experience working alongside EMS professionals who regularly use KED EMS equipment in trauma situations requiring careful patient handling and transfer.
Ked ems word guide:
Understanding KED EMS Fundamentals
The Kendrick Extrication Device is more than just a piece of equipment—it's a carefully engineered system designed to provide maximum stability with minimal movement during patient extrication. To fully appreciate its role in emergency medicine, it's important to understand its construction, components, and how it fits into modern EMS protocols.
When you first handle a KED, you'll notice its unique construction of wooden or polymer slats nestled inside a tough nylon jacket. This clever design gives the device vertical rigidity where it's needed to support the spine, while maintaining horizontal flexibility to wrap comfortably around patients. Weighing in at just 7-8 pounds, the KED is remarkably portable yet sturdy enough to support patients up to 550 pounds.
Back in 1978, Richard Kendrick faced a challenge: how to safely remove injured race car drivers from their confined cockpits. His solution—the wrap-around vest we now know as the KED—revolutionized patient extrication by immobilizing the head, neck, and torso in a neutral position, dramatically reducing the risk of secondary spinal injuries.
One of the most thoughtful features of the KED EMS system is its color-coded straps. This simple but brilliant design helps first responders quickly identify the correct application sequence, even when adrenaline is pumping and seconds count. Many modern KEDs are also radiolucent (except for those metal buckles), allowing medical teams to take X-rays without removing the device.
"I've used KEDs for over a decade," shares a veteran paramedic. "What I appreciate most is how it balances rigidity with flexibility—firm enough to keep the spine stable but adaptable enough to fit different body types and vehicle configurations."
Components & Features at a Glance
The heart of any KED EMS system is its rigid support structure—those wooden or polymer bars that provide crucial vertical support while allowing the device to bend horizontally for a snug fit. The torso section features three color-coded straps (typically green, yellow/orange, and red) that secure the patient's upper body.
Head immobilization comes from two dedicated straps that work in conjunction with the Adjusta-Pad™ neck roll, which provides customizable cervical support and fills any gaps between the patient's neck and the device. For lower body stability, two leg straps often form a continuous loop through the spine of the device—an ingenious feature that improves stability during challenging extrications.
The snap-lock buckles deserve special mention for allowing quick, secure fastening even when wearing gloves. And don't overlook the carrying case—it not only protects your KED but ensures compact storage on emergency vehicles where space is always at a premium.
Some newer models feature a deceleration shoulder strap system that prevents patient movement during sudden stops—a thoughtful addition that shows how this device continues to evolve with real-world experience.
How KED Fits into Modern KED EMS Kits
Despite ongoing debates about its effectiveness compared to newer techniques, the KED remains a critical supply on ambulance standards checklists in many jurisdictions. This speaks volumes about its continued importance in the EMS toolkit.
Today's KEDs often include rope-rescue compatibility, making them versatile tools for technical rescue scenarios beyond vehicle extrications. The integrated carrying case allows for compact storage and quick deployment when those critical moments arrive.
When comparing immobilization devices, each has its sweet spot in patient care:
| Device | Primary Use | Advantages | Limitations | Application Time |
|---|---|---|---|---|
| KED | Vehicle extrication with suspected spinal injury | Better cervical immobilization, fits in confined spaces | Longer application time, limited use in unstable patients | 6.63 minutes (avg.) |
| Backboard | Full-body immobilization, patient movement | Quick application, full-body support | Patient discomfort, pressure injuries, questionable benefit | 0.74 minutes (avg. with rapid extrication) |
| Scoop Stretcher | Patient transfer with minimal movement | Minimal lifting required, splits for application | Limited spinal support, not suited for confined spaces | 1-2 minutes (approx.) |
"In our service, we've seen a shift toward using scoops more frequently than backboards," notes an EMS instructor from the Southeast. "But we still train extensively on KED application because there are specific situations where it's simply the best tool for the job."
At American Mortuary Coolers, we understand the importance of proper patient handling equipment throughout the entire care continuum. While our focus is providing quality mortuary coolers and related equipment for the funeral industry, we recognize and respect the critical role that devices like the KED play in emergency care—where proper immobilization can make all the difference in a patient's outcome.
When to Use (and Skip) the KED
Knowing when to deploy the KED is as important as knowing how to use it. The device is not a one-size-fits-all solution, and EMS professionals must make rapid decisions about its appropriateness based on patient condition, mechanism of injury, and scene safety.
Primary Indications for KED Use:
The KED shines in several specific scenarios. It's particularly valuable for motor vehicle collisions where spinal injuries are suspected but not immediately life-threatening. The ideal candidate is a hemodynamically stable patient who can wait those extra minutes for proper immobilization.
The device truly proves its worth during confined space extrications where maintaining spinal alignment is tricky. For seated patients who need immobilization before being moved, the KED's design offers superior protection compared to other options.
Research backs this up. A study in the Western Journal of Emergency Medicine found that KED EMS provides better cervical spine immobilization than rapid extrication techniques. After transfer to a backboard, patients with KEDs showed mean right head turns of just 20.6° compared to 30.8° with rapid extrication. Similarly, mean left head turns were only 21.6° with KED versus 26.9° with rapid extrication.
But as helpful as the KED can be, there are times when it's simply not the right tool for the job.
When to Skip the KED:
Sometimes, the KED does more harm than good. For unstable patients with critical injuries, those extra 6+ minutes of application time could make the difference between life and death. As one paramedic told me, "When seconds count, you can't afford to spend minutes on a KED."
With penetrating trauma like gunshot or stab wounds, research shows that delaying transport for spinal immobilization actually increases mortality rates. As a veteran EMS provider bluntly stated in an online forum: "Using boards for penetrating trauma delays transport and increases mortality."
Scene safety concerns always trump immobilization protocols. If the vehicle is unstable, on fire, or leaking hazardous materials, get the patient out fast—no KED required.
Interestingly, obesity presents unique challenges for KED use. Studies indicate that heavier patients actually experienced increased movement with the KED compared to rapid extrication, suggesting the device may be less effective for larger body types.
When patients block access to other, more critically injured victims, rapid extrication without a KED is often the better choice.
"Always remember your ABCs," a 20-year paramedic once told me. "Airway, Breathing, and Circulation take priority over spinal immobilization. If you're spending precious minutes applying a KED while your patient's condition is deteriorating, you've missed the point entirely."
For the little ones, pediatric patients require special consideration. While the KED can work for children, it needs additional padding to ensure proper fit without compromising breathing. Many services carry pediatric-specific immobilization devices that might be more appropriate.
Decision Algorithm for KED EMS Field Use
To help make these tough calls in the field, many EMS services follow a simple decision tree. First, assess the scene: Is it safe? Is the vehicle stable? If the answer to either question is no, skip the KED and perform rapid extrication.
Next, evaluate the patient: Are they unstable? Do they have penetrating trauma? Are they blocking access to more critical patients? Again, if yes to any of these, rapid extrication is preferred.
Finally, consider practical matters: Can you apply the KED without causing undue pain? Is the patient's body type compatible with the device? If not, other options might be better.
Many EMS instructors teach the "SMART" mnemonic to help providers remember when to Skip the KED:
Scene unsafe Mortality risk high (unstable patient) Access blocked to other patients Rapid transport needed Trauma is penetrating
The medical community's thinking on spinal immobilization has evolved over the years. The National Association of EMS Physicians (NAEMSP) now recognizes that we need to balance potential benefits against known harms like delayed transport and patient discomfort. Their guidelines emphasize selective rather than routine spinal immobilization for trauma patients.
At American Mortuary Coolers, we appreciate the careful judgment EMS professionals exercise when deciding whether to use tools like the KED. While our focus is providing quality mortuary coolers nationwide, we understand that proper patient care requires making tough calls about when—and when not—to use specialized equipment. This thoughtful approach to patient care is something we deeply respect in our emergency services partners.
Step-by-Step Application Guide
When you've determined that using the KED is appropriate for your patient, proper application technique is critical for both effectiveness and efficiency. The following step-by-step guide will walk you through the process of applying the KED safely and correctly.
Preparation and Initial Assessment
Before diving into KED application, safety comes first. Make sure the scene is secure and complete your initial patient assessment. While maintaining manual in-line stabilization of your patient's neck, apply an appropriately sized cervical collar. Remember to talk to your patient throughout this process – a simple explanation of what you're doing helps reduce anxiety and improves cooperation.
"I always tell my patients exactly what I'm doing and why," shares Sarah, a paramedic with 12 years of experience. "It takes just seconds but makes a world of difference in how they respond to treatment."
KED Application Procedure
Positioning the KED correctly sets the foundation for successful immobilization. Gently slide the folded device behind your patient's back, between their body and the seat. Make sure the bottom edge aligns with their buttocks, then carefully unfold the side panels under their arms.
Many ked ems professionals use a helpful mnemonic to remember the correct strap sequence: "My Baby Looks Hot Tonight." This simple phrase helps you recall that you should secure the Middle torso strap (yellow/orange) first, followed by the Bottom torso strap (red), then the Leg straps (black), the Head straps, and finally the Top torso strap (green).
The middle strap goes first because it stabilizes the device without restricting breathing. Once that's secure, apply the bottom torso strap, then move to the leg straps – typically crossing them unless there's a groin injury. With the torso and legs secured, you can focus on immobilizing the head with straps while ensuring neutral alignment. The top torso strap comes last, just before moving your patient.
"The reason we leave the top torso strap for last," explains Mark, a paramedic instructor, "is to allow the patient to breathe more easily while we're securing the rest of the device. It's a small consideration that can make a big difference in patient comfort."
Don't forget to pad any gaps between your patient's head and the device. This ensures proper immobilization and prevents painful pressure points during transport.
KED EMS Application Checklist
To make sure nothing falls through the cracks during a high-stress situation, use this simple checklist:
- ✓ Scene and patient assessment completed
- ✓ Manual in-line stabilization maintained
- ✓ Cervical collar applied
- ✓ KED positioned correctly behind patient
- ✓ Middle torso strap secured
- ✓ Bottom torso strap secured
- ✓ Leg straps applied and secured
- ✓ Head immobilized with straps and padding
- ✓ Top torso strap secured
- ✓ Breathing and circulation reassessed
- ✓ Patient rotated as a unit onto backboard
- ✓ Patient secured to backboard
- ✓ Circulation, Sensation, and Movement (CSM) checked
When it's time to transfer your patient, rotate them as a single unit onto a backboard or stretcher. Secure them with additional straps and immediately reassess their condition, including vital signs and neurological status. If you're using a radiolucent KED, it may stay in place during imaging. Otherwise, plan for safe removal once your patient is secured to the backboard or at the receiving facility.
Tips to Reduce Scene Time
We all know that ked ems application takes significantly longer than rapid extrication – 6.63 minutes versus 0.74 minutes on average. That's why efficiency matters. Using a two-rescuer technique can dramatically speed things up – one provider maintains manual stabilization while the other applies the KED.
Regular practice makes perfect. "In our department, we run KED drills monthly," shares an EMS captain from Johnson City, TN. "We've cut our average application time from over 8 minutes to under 5 minutes through consistent practice and technique refinement."
Smart equipment staging also saves precious seconds. Have your KED unfolded and straps laid out for quick application before you begin. Setting timer benchmarks for your team creates healthy competition and motivation to improve. And clear, consistent communication eliminates confusion when seconds count.
At American Mortuary Coolers, we understand the importance of handling patients with care and efficiency at every stage. While our custom mortuary coolers serve a different purpose than emergency equipment, we share the EMS community's commitment to dignity and proper care in all patient handling.
Does the Science Support KED?
As with many long-standing medical practices, the use of the KED EMS has come under scientific scrutiny in recent years. Understanding the evidence for and against KED use is essential for informed protocol development and clinical decision-making.
The Research Evidence
When we look at the data, the picture becomes more complex than many of us were taught in EMT school. A pivotal study in the Western Journal of Emergency Medicine compared the KED with rapid extrication techniques and uncovered some eye-opening findings.
First, there's the time factor. KED application took substantially longer than rapid extrication—an average of 6.63 minutes compared to just 0.74 minutes for rapid techniques. That's nearly a 9-fold difference in time spent on scene!
On the plus side, the KED did prove better at restricting neck movement. After transfer to a backboard, patients with the KED showed a mean right head turn of 20.6° versus 30.8° with rapid extrication. That's a meaningful reduction in potential movement.
Surprisingly though, when researchers asked patients about comfort, they found no statistical differences in pain levels between the two techniques. This challenges the assumption that more immobilization automatically means more comfort for the patient.
Perhaps most concerning for many EMS providers was the findy that heavier patients actually experienced increased movement with the KED compared to rapid extrication. This suggests the device may be less effective for the very patients who might seem most vulnerable to movement-related injuries.
"We've been using the KED for decades based on the theoretical benefit of spinal immobilization," a seasoned EMS medical director told me recently. "But when we look at actual patient outcomes, it's hard to find clear evidence that it makes a significant difference in preventing secondary spinal injuries."
This sentiment was echoed in a thoughtful 2015 critique in the Journal of Paramedic Practice, which questioned whether we have sufficient evidence to support the KED's continued prominence in patient care.
Cost and Resource Considerations
Let's talk dollars and cents for a moment. A typical KED costs around $100, with replacement straps running about $13.50. For cash-strapped rural EMS services operating multiple ambulances, that's a meaningful investment in equipment that may not be delivering the benefits we once assumed.
As one straight-talking paramedic noted in an online discussion, "Some states still legally require both backboards and KEDs on every ambulance, despite mounting evidence that questions their routine use. That's money that could go toward equipment with clearer benefits."
Evolution of Guidelines
The good news is that the EMS world is responding to the evidence. Many systems have begun revising their spinal immobilization protocols, shifting from the old "board everyone" approach to more nuanced, patient-centered care.
The current trends I'm seeing across the country include more selective spinal immobilization using clinical decision rules to determine who truly needs immobilization. There's also a welcome move toward reduced backboard use, limiting long boards to extrication only rather than transport.
Many progressive services are embracing alternative devices like scoop stretchers and vacuum mattresses that may provide adequate immobilization with less discomfort. And there's a renewed emphasis on proper C-collar application with minimal movement, rather than full-body immobilization for every potential spinal case.
Balancing Safety and Speed
The million-dollar question facing every EMS provider becomes: Does the additional motion restriction provided by the KED justify the extended scene time?
For stable patients with concerning mechanisms in safe environments, the answer might still be yes. The KED does provide better immobilization than rapid techniques, which could potentially prevent secondary injury.
However, we need to weigh this theoretical benefit against several practical concerns. Extended scene times can delay definitive care, which we know negatively impacts outcomes for many conditions. The awkward positions required during KED application can increase the risk of provider injuries – something I've experienced during a particularly challenging extrication from a compact car.
There's also the issue of resource allocation. Those extra 5-6 minutes spent applying a KED tie up an ambulance that might be needed for another call. And let's not forget the patient experience – longer immobilization typically means increased discomfort, anxiety, and sometimes respiratory compromise.
"It's about balancing risks," explained a paramedic friend with 20 years of street experience. "Yes, the KED restricts spinal movement better than rapid extrication. But if that comes at the cost of delaying critical interventions by 5-6 minutes, the net benefit might actually be negative for many patients."
At American Mortuary Coolers, we follow these evolving practices with interest, as they inform our own approaches to dignified, safe handling throughout the continuum of care. Our custom mortuary coolers are designed with similar attention to safety, efficiency, and respect—principles that align with the best practices in emergency medicine.
Special Scenarios, Alternatives & FAQs
Even though the KED EMS is a go-to tool for many EMS situations, real-life emergencies rarely follow the rules. Every patient is different—and sometimes, even the best-laid protocols need a creative twist. Let’s explore some unique scenarios, clever alternative uses, and the most common questions crews have about KED EMS in the field.
Special Patient Populations
Pediatric Patients:
Kids just aren’t little adults. Their bodies are shaped differently, and that means the KED EMS sometimes needs extra padding to keep their heads and necks in line. Always check for gaps and use towels or blankets as needed. Some squads carry pediatric-sized immobilization gear, which can be a better fit. As one pediatric specialist puts it: “With children, over-padding is better than under-padding—comfort and safety go hand-in-hand.”
Pregnant Patients:
Pregnant patients, especially in the later months, need special care. The standard KED EMS technique may put pressure on the belly, which isn’t good for mom or baby. To help, wedge some padding under the right hip—this tips the uterus off the big blood vessels and helps with blood flow. And keep the straps snug, but never tight across the abdomen. Be ready for changes in blood pressure when moving or turning.
Obese Patients:
Though the KED EMS is rated for up to 550 lbs, research has shown that the device may actually allow a bit more movement in heavier patients. In those cases, you might get better immobilization with a scoop stretcher and some extra side supports, or just stick to manual stabilization and rapid extrication. A vacuum mattress can also work wonders when you need to mold support to larger body shapes.
Creative KED Applications
EMS crews are famous for thinking on their feet. Over the years, many have found off-label uses for the KED EMS—especially in tight spots where nothing else fits.
The Upside-Down KED Pelvic Binder:
Flip the KED upside down and you’ve got an improvised pelvic splint. This can be a lifesaver for suspected pelvic fractures, especially in cramped bathrooms or awkward car positions. The bottom edge goes a few inches above the iliac crests, padding goes where it’s needed, and the torso straps wrap around the pelvis for stabilization. Some crews even wrap the head flaps around the legs for extra security.
Makeshift Hip Fracture Splint:
Need to stabilize a fractured hip? Slide the KED (still upside-down) under the patient’s hips, pad the sore spot, and use the straps to snug up around the pelvis and thighs. The carrying loops can double as makeshift handles to help with lifting.
As one paramedic in Dallas joked, “If it fits in the room and can wrap around a leg, the KED is coming with me.”
Alternative Immobilization Devices
Protocols are always evolving, and new gear often takes center stage. In many regions, scoop stretchers and vacuum mattresses are now the frontline tools for patient movement and immobilization.
- Scoop stretchers are great for minimizing movement during transfers, and they fit where backboards won’t.
- Vacuum mattresses offer customized support and comfort, especially for longer transports.
- When spinal immobilization isn’t the top priority, tools like the MegaMover are lightweight and strong, making tricky moves safer for both patient and crew.
Curious about how these stretchers compare? Check out this detailed guide on the differences between stretchers.
Off-Label Tricks Every KED EMS Crew Should Know
Veteran EMS crews are never short on hacks. Some KED models have been used for vertical haul rescues in technical situations, thanks to the continuous leg strap and sturdy handles. Others love the fold-back sides for quick chest access—handy if a patient’s condition suddenly takes a turn. For small children, the KED can even act as a full-body immobilizer, giving extra stability where standard devices fall short.
Frequently Asked Questions about KED EMS
What if my patient vomits while in a KED?
This is always a worry. If your patient starts to vomit, immediately turn both the patient and the KED as a unit to the side. Suction if you need to, and loosen the top strap for better access—just keep manual stabilization on the head and neck throughout.
Can the KED stay on during CT scans or X-rays?
Modern KED EMS devices are usually radiolucent except for the metal buckles, so most X-rays are fine. However, CT scans might show artifacts from the metal parts. Always check your local protocol and know your gear’s details.
How often should straps be replaced?
Inspect straps and buckles before every use. Replace them if you see any fraying, stretching, or broken parts. Many EMS agencies set a schedule—often every 6–12 months—just to be safe.
Is the KED really being phased out?
There’s definitely a trend toward selective use. Some EMS services are using the KED EMS less often, but many still require it on every ambulance. The key is knowing when it’s the right tool for the job.
How do I clean and disinfect a KED?
Wipe off any dirt with soap and water first. Then disinfect using an approved hospital-grade cleaner. Let it dry thoroughly before folding and storing it away. And of course, document each cleaning as required by your agency’s infection control policy.
At American Mortuary Coolers, we believe every tool has its place and every patient deserves respect—whether it’s a custom mortuary cooler or a trusted KED EMS. The right equipment, the right training, and a little creative thinking can make all the difference when the call comes in.
Conclusion
The Kendrick Extrication Device has been a mainstay in emergency medical services for over four decades, and understanding its proper use, limitations, and alternatives is essential for every EMS professional. As we've explored throughout this guide, the KED EMS approach to patient care requires balancing the benefits of superior spinal immobilization against the costs of extended scene time and resource allocation.
When I first started training EMTs on KED application, I was struck by how passionate experienced providers were about this seemingly simple device. Some swore by it, while others questioned its continued relevance. That tension reflects where we stand today in emergency medicine—balancing tradition with evolving evidence.
The research clearly shows that while the KED provides better cervical spine immobilization than rapid extrication techniques, this benefit comes with a significant time cost—6.63 minutes versus 0.74 minutes on average. That's nearly six additional minutes on scene, which can feel like an eternity when you're kneeling beside a crashed vehicle.
What's become increasingly clear is that not every trauma patient needs a KED. The thoughtful provider uses clinical judgment and follows local protocols to determine when this device truly benefits the patient versus when rapid extrication makes more sense. It's about matching the right tool to the right situation.
"I've been in EMS for 22 years," shared a paramedic from Nashville, "and I've seen the pendulum swing from 'board everyone' to much more selective immobilization. The KED still has its place, but we're smarter about when we use it now."
Proper technique matters tremendously. I've seen well-intentioned providers struggle with strap sequencing or padding placement, undermining the device's effectiveness. Following the recommended application steps—securing the torso before immobilizing the head, ensuring proper padding—makes all the difference in both effectiveness and patient comfort.
One of the things I love about EMS professionals is their creativity. The versatility of the KED has led to innovative uses beyond its original design. That upside-down KED technique for pelvic stabilization? Pure field ingenuity. These adaptations show how a well-designed tool can solve problems its inventor never anticipated.
At American Mortuary Coolers, we understand this kind of practical problem-solving. While we specialize in custom mortuary coolers rather than emergency equipment, we share the EMS community's commitment to finding thoughtful solutions that respect both the living and the deceased. Our durable, custom-designed coolers reflect the same attention to detail that goes into proper KED application.
As EMS protocols continue to evolve, so will the role of the KED. The best providers stay informed about changing guidelines and research while maintaining their technical skills through regular practice. The fundamental principles remain constant: patient safety, careful assessment, and thoughtful decision-making.
We're proud to support the emergency medical community through our understanding of the full continuum of care. From the moment emergency care begins to final arrangements, dignity and proper handling matter deeply. Our commitment to quality, customization, and direct delivery across the contiguous 48 states mirrors your dedication to excellence in patient care.
For those interested in learning more about our products or how we support both the EMS and funeral industries, please visit More details on Mobi Medical equipment.
Continuous training, regular equipment inspection, and staying current with best practices aren't just professional responsibilities—they're how we honor the trust patients place in us. The KED, when used appropriately, remains a valuable tool in the EMS arsenal—one that can make a critical difference when seconds and millimeters matter.