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Handtevy - Pediatric Emergency Standards, Inc., 11860 SR-84 Suite B1, Davie, FL (2026)

03/13/2026

𝗜𝗻𝘁𝗿𝗼𝗱𝘂𝗰𝗶𝗻𝗴 𝘁𝗵𝗲 𝗛𝗮𝗻𝗱𝘁𝗲𝘃𝘆 𝗘𝗠𝗦 𝗜𝗻𝗻𝗼𝘃𝗮𝘁𝗶𝗼𝗻 𝗦𝘆𝗺𝗽𝗼𝘀𝗶𝘂𝗺: 𝗭𝗲𝗿𝗼 𝗠𝗮𝗿𝗴𝗶𝗻💥 EMS's sharpest clinicians. One stage. Four hours. Zero filler. The hottest topics in prehospital care—debated, dissected, and challenged like never before because in emergency medicine... the margin for error is razor thin.

🗓️ May 27 | 1–5 PM | Austin, TX at EMS World Live.
💪 Full agenda, speaker lineup & registration → https://www.handtevy.com/science-innovation-symposium-2026/

03/12/2026

𝐒𝐮𝐢𝐜𝐢𝐝𝐞 𝐤𝐢𝐭𝐬 are becoming more prevalent.

Clinicians need to know what this poisoning looks like and how to treat it in the field.

Your patient is cyanotic, unresponsive, and not improving with 100% oxygen. The pulse ox reads 85%… but the blood in the IV line looks dark brown.

𝐖𝐡𝐚𝐭'𝐬 𝐠𝐨𝐢𝐧𝐠 𝐨𝐧?
A recently published case report highlights a rare but increasingly recognized toxicologic emergency: 𝐬𝐨𝐝𝐢𝐮𝐦 𝐧𝐢𝐭𝐫𝐢𝐭𝐞 𝐩𝐨𝐢𝐬𝐨𝐧𝐢𝐧𝐠 𝐜𝐚𝐮𝐬𝐢𝐧𝐠 𝐬𝐞𝐯𝐞𝐫𝐞 𝐦𝐞𝐭𝐡𝐞𝐦𝐨𝐠𝐥𝐨𝐛𝐢𝐧𝐞𝐦𝐢𝐚, and the lifesaving role EMS can play by administering methylene blue in the prehospital setting.

𝐓𝐡𝐞 𝐂𝐚𝐬𝐞:
An 18-year-old male was found unconscious at home with profound cyanosis and vomiting.
On ALS arrival: GCS of 4, severe dyspnea, SpO₂ ~85% despite 100% oxygen.

Naloxone and flumazenil had no effect.

During IV access, clinicians noticed dark "chocolate-colored" blood, a classic clue for methemoglobinemia.

This is a condition where hemoglobin is oxidized and unable to carry oxygen effectively, causing severe tissue hypoxia even when PaO₂ is normal.

𝐓𝐡𝐞 𝐒𝐚𝐯𝐞
The ALS team recognized the pattern and administered methylene blue in the field, the antidote that converts methemoglobin back into functional hemoglobin. The patient was intubated and transported.

In the ED, blood gas confirmed methemoglobinemia at 30%. After a second dose of methylene blue, levels dropped from 30% to 8% within five minutes. The patient was extubated in six hours and discharged the next day without complications.

The first methylene blue dose was given approximately 15 minutes after EMS arrival. That speed likely prevented a fatal outcome.

𝐓𝐡𝐞 𝐒𝐲𝐬𝐭𝐞𝐦 𝐁𝐞𝐡𝐢𝐧𝐝 𝐭𝐡𝐞 𝐒𝐚𝐯𝐞
This wasn't luck. After previous sodium nitrite deaths in the region, ALS units were proactively equipped with methylene blue, allowing field physicians to treat suspected methemoglobinemia immediately. That's what system-level preparedness looks like.

𝐊𝐞𝐲 𝐂𝐥𝐢𝐧𝐢𝐜𝐚𝐥 𝐂𝐥𝐮𝐞𝐬 𝐟𝐨𝐫 𝐄𝐌𝐒:
Persistent cyanosis with SpO₂ ~85–89% despite high-flow O₂, chocolate-colored blood, and hypoxia that doesn't correlate with oxygen delivery should raise immediate suspicion for methemoglobinemia.

𝐁𝐨𝐭𝐭𝐨𝐦 𝐋𝐢𝐧𝐞:
As sodium nitrite su***de kits become more accessible, EMS systems need both the awareness and the antidote on the truck. Early recognition and prehospital methylene blue can be the difference between life and death.

📚 Read the Full Study:https://media.handtevy.com/website/Early-Recognition-and-Management-of-Severe-Sodium-Nitrite-Intoxication-A-Case-Report-Emphasizing-Prehospital-Administration-of-Methylene-Blue.pdf

03/09/2026

Your crew is called for an agitated patient.

Law enforcement is requesting assistance with patient restraint.

Does your statewide protocol clearly guide what happens next?

A new study in Prehospital Emergency Care reviewed EMS statewide agitation protocols in 2018 vs 2025 and compared them to the 2021 NAEMSP position statement.

Here’s what changed:
➡️ Verbal de-escalation increased from 66% of protocols in 2018 to 100% in 2025. Every statewide protocol now recommends it.
➡️ Standardized agitation scoring (RASS, BARS, etc.) increased from 10% to 29%, but still appears in less than one-third of protocols.
➡️ Monitoring after restraint or sedation increased from 55% to 71%. That means nearly 30% of statewide protocols still do not clearly recommend post-sedation monitoring.
➡️ Ketamine inclusion jumped from 55% to 87% of protocols over seven years. Meanwhile, benzodiazepines are now included in 100% of statewide protocols.
➡️ Only 3 states included all 11 recommended elements from the NAEMSP guidance.

Bottom line: Agitation management protocols are evolving, especially around verbal de-escalation and ketamine use, but many statewide guidelines still lag behind national recommendations, particularly in standardized assessment and patient monitoring.

This is a great time for agencies and medical directors to ask: Does our protocol match best practice?

Full study link here:
https://media.handtevy.com/website/Evolution-Over-Time-of-EMS-Statewide-Treatment-Protocols-on-Prehospital-Agitation-in-the-United-States.pdf

03/06/2026

It's 𝗧𝗲𝗮𝗺 𝗠𝗲𝗺𝗯𝗲𝗿 𝗦𝗽𝗼𝘁𝗹𝗶𝗴𝗵𝘁 time! 🚀 This month we’re shining the spotlight on someone who brings excellence, mentorship, and heart to the team every single day. Meet Jessica, our Senior Business Development manager, who has been instrumental in supporting new team members, strengthening sales processes, and uplifting everyone around her.

𝗪𝗵𝘆 𝗝𝗲𝘀𝘀𝗶𝗰𝗮 𝗦𝘁𝗮𝗻𝗱𝘀 𝗢𝘂𝘁 🌟
From the moment teammates join the company, Jessica makes them feel welcomed, supported, and valued. Whether she’s mentoring, solving challenges, or simply showing up with a positive attitude, she brings dedication, intelligence, and heart to everything she does.

𝗙𝘂𝗻 𝗙𝗮𝗰𝘁!
Jessica’s talents go beyond sales—she’s a former middle school math teacher! When she’s not supporting the team, she’s spending time with her two sweet boys at home.

03/03/2026

Your trauma patient is awake, alert, and complaining of neck pain after a rollover MVC.
Do you still reach automatically for the rigid collar and backboard?

After 80+ years of spinal immobilization, there's still no evidence it prevents neurological deterioration.....but plenty showing it causes harm.

Tim Nutbeam's new editorial in Prehospital Emergency Care makes the case for gentle patient handling: coordinated, patient-centered movement that achieves similar biomechanical outcomes without the distress of rigid collars and boards.

The shift isn't abandoning spinal protection, it's delivering it smarter.

Perfusion may matter more than small movements. Patients naturally guard against painful motion.

Systems worldwide that have moved away from routine rigid immobilization have done so safely.

Medicine moves forward at exactly these uncomfortable inflection points.

Full article here:
https://media.handtevy.com/website/Reconsidering-Spinal-Immobilization-Evidence-Evolution-and-the-Case-for-Gentle-Patient-Handling.pdf

02/26/2026

Should vacuum mattresses be grouped with backboards?

Today we discuss a thoughtful new critique worth reading.

The recent NAEMSP spinal cord injury compendium by Millin et al. is an impressive and comprehensive piece of work, a much-needed synthesis of the evidence on spinal immobilization.

But a just-published letter to the editor in Prehospital Emergency Care by Billin & Lowe raises a nuance worth discussing: by defining "backboard" broadly enough to include vacuum mattresses, did the compendium inadvertently paint them with the same brush?

The numbers are interesting. Of 43 studies cited for harms of spinal immobilization, only 6 even mention vacuum mattresses.

And the methodology in several of those is questionable. One actually showed vacuum mattress pressures were significantly LOWER than unpadded spine boards, another used an outdated cervicothoracic collar setup that doesn't reflect modern practice.

This distinction matters, especially in austere and wilderness environments where non-ambulatory patients need to be moved over difficult terrain and there's no ambulance cot waiting nearby. Vacuum mattresses offer thermal insulation, better pressure distribution, superior stability, and portability that rigid boards simply can't match.

A 2025 review of 28 studies recommends vacuum mattresses over backboards to improve outcomes and reduce complications.

This is what good academic discourse looks like, a strong compendium inviting rigorous scrutiny that sharpens our understanding. The takeaway for medical directors: make sure your protocols distinguish between these devices rather than treating them as equivalent.

Right tool. Right scenario. Right patient.

📚 Read the full letter here:https://media.handtevy.com/website/Prehospital-Management-of-Suspected-Spinal-Cord-Injuries-Have-Vacuum-Mattresses-Been-Inappropriately-Maligned-.pdf

02/19/2026

You arrive on scene as a physician responder in an SUV ➙ ultrasound in the back, field amputation & thoracostomy kit ready.

Is this the future of EMS in the U.S.?

A new national survey of ACGME-accredited EMS fellowships examined the use of Physician Response Vehicles (PRVs) — and the results show they’re becoming the norm.

Out of 79 programs, 92% responded:
• 69% currently have a PRV
• 14% are actively acquiring one
• Only 18% have no plans for a PRV

🚑 How are they used?
• 45% self-dispatch
• 13% automatically dispatched to specific calls
• 18% dispatched upon EMS request
• 28% provide 24/7 coverage
• 40% respond to 500 calls/year

🔧 What are they carrying? (Table 2 & 3)
• Ultrasound – 86% perform it
• Thoracostomy – 86%
• Field amputation – 76%
• Blood administration – 43%
• Only 10% carry blood onboard

📈 More hours in service = more procedures
Programs operating >29 hrs/week allowed a median of 6.5 procedures vs 4 procedures for those

02/18/2026

Kudos to our colleagues in Michigan for advancing pediatric EMS safety 👏🚑

A new study just published in Prehospital Emergency Care (MI-PEERS) shows the kind of commitment to pediatric patient safety that makes our whole field better. This research team invested years into developing and testing a comprehensive drug dosing safety system, and had the courage to share what worked and what didn't.

What we love about this study:
► Rigorous simulation-based methodology with direct observation, the gold standard for identifying errors that chart reviews miss
► The checklist concept worked and crews who used it achieved 80.8% dosing accuracy vs. 53% without. That's a powerful finding.
► Significant reduction in errors of omission for anaphylaxis showing that focused education on "epinephrine fast and first" makes a real difference
►A true team approach involving dispatchers, EMTs, and paramedics working together

The study also highlights the challenge our entire industry faces:
👉 Even with extensive training, regular practice problems, dosing references, and motivated providers, ❗overall error rates remained around 34% ❗
👉 The authors themselves conclude that system-based solutions, not just more training, are the path forward.

We couldn't agree more. Building systems where the right dose is built into the workflow so providers can focus on the patient, not the math.

The study also identified a serious safety concern around D10 administration in pediatric patients that the whole EMS community should be aware of.

Thank you to Dr. Hoyle and the entire MI-PEERS team for this important contribution. Research like this makes all of us better. 🙏

📄 Hoyle et al., Prehospital Emergency Care, 2026
📚 Full study:https://media.handtevy.com/website/Effect-of-a-drug-dosing-safety-bundle-initiative-to-improve-pediatric-drug-dosing-by-paramedics.-Results-of-the-Michigan-Pediatric-EMS-Error-Reduction.pdf

02/12/2026

Meet 𝗖𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗦𝗰𝗼𝗿𝗲𝘀 🩺📲 Handtevy Mobile's 𝗡𝗘𝗪𝗘𝗦𝗧 feature upgrade that transforms standardized assessment tools into intelligent workflows that drive real-time clinical decisions. From APGAR to GCS to RACE, your scores now come with configurable rules and instant interpretations that automatically deliver the guidance your team needs. Scores aren't just recorded—they're put to work.

✅ Evidence-based tools (APGAR, GCS, RACE, CP-SSS & more)
⚡ Configurable rules that trigger your protocols
📋 Seamless integration into documentation

Ready to make your clinical scores work smarter? Your organization's admin can enable the feature today!

Don't have Handtevy Mobile? No problem! Let's get you locked in with a demo today 💪 Click here to begin >> https://www.handtevy.com/request-a-demo/

02/11/2026

Your pediatric patient is in respiratory distress.
You manage the airway, give oxygen, and prepare for transport.

But how do you know if the care you provided actually meets the mark?

For most EMS agencies, the answer is: you don't.

There has never been a standardized set of quality measures focused on pediatric prehospital care.

Until now.

A new study in Prehospital Emergency Care convened a national expert panel that identified 24 quality measures spanning airway management, trauma, pain control, respiratory emergencies, cardiac arrest, anaphylaxis, shock, seizures, hypoglycemia, newborn emergencies, non-transport, and safe transport.

Here are Some Examples:
→ Children with asthma exacerbation who receive albuterol
→ Pediatric trauma patients transported to trauma centers
→ Children with anaphylaxis who receive epinephrine
→ Status epilepticus patients who receive a benzodiazepine
→ Non-transported pediatric patients with a full set of vitals documented

Why EMS agencies should care?
Over half apply to BLS. Nearly all are process measures, trackable and actionable regardless of agency size or call volume. They plug directly into NEMSIS dashboards, so agencies can benchmark performance and identify gaps without building QI infrastructure from scratch.

Bottom line:
Pediatric calls are low frequency but high risk. This gives your agency an evidence-based framework to measure and improve pediatric care, no matter where kids encounter the 911 system.

📄 Read the full study:
https://media.handtevy.com/website/Establishing-Quality-Measures-for-the-Prehospital-Pediatric-Readiness-Project.pdf

02/10/2026

Handtevy Mobile’s 𝙎𝙢𝙖𝙧𝙩 𝙌𝙪𝙞𝙯𝙯𝙚𝙨—Delivering fast, focused learning powered by AI and built by your organization📱Upload your content. Generate quizzes with AI. Track progress instantly. Smart Quizzes helps your teams train continuously and confidently, right inside the app ⚡

Stay sharp. Stay ready. 💪 Available in the latest version of Handtevy Mobile with your current subscription.

Ready to see it in action? Schedule a demo today >> https://www.handtevy.com/request-a-demo/

02/09/2026

A new study out of Australia looked at what happened after a statewide EMS system stopped using semi-rigid cervical collars and transitioned to soft collars for trauma patients.

Ambulance Victoria made the switch in 2021. This paper examined downstream effects at a major trauma center.

Here’s what they found:

📊 Imaging & clearance
• CT C-spine rates increased (93.9% vs 88.4%)
• Patients were 4× more likely to have their cervical spine cleared in the ED
• Only 21.6% of patients in soft collars left the ED still immobilized vs 53.2% with semi-rigid collars

🧠 Patient outcomes
• No statistically significant difference in spinal cord injury
• No meaningful difference in pressure sores
• No meaningful difference in hospital-acquired pneumonia

📉 Important limitations
• Not powered to detect very small differences in spinal cord injury.
• Single-center trauma study
• More elderly and fall-related trauma in the soft-collar group

🔎 Why this matters
Read on its own, this study shows that moving away from rigid collars did not lead to worse patient outcomes in a real-world EMS system.

Read alongside The National Association of EMS Physicians - Naemsp Trauma Compendium by Dr. Mike Millin and colleagues, it becomes more interesting.

The NAEMSP paper challenges the long-held assumption that post-injury spinal movement is the primary driver of delayed neurologic injury, and highlights stronger evidence for hypoperfusion, hypotension, and secondary ischemia, while also detailing the very real harms associated with immobilization.

The Australian data doesn’t resolve every question, but it shows what happens when a system acts on that evolving evidence.

No safety signal emerged.
But downstream care changed.

This study doesn’t end the cervical spine debate, but it helps EMS leaders place theory next to practice as they rethink how spinal protection should look in modern prehospital care.

Read the full study here:https://www.handtevy.com/wp-content/uploads/2025/11/2024-Australian-Soft-Collar.pdf

Handtevy - Pediatric Emergency Standards, Inc.

03/13/2026

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