Handtevy - Pediatric Emergency Standards, Inc.

Handtevy - Pediatric Emergency Standards, Inc. Pediatric Emergency Standardโ€™s mission is to improve the quality of pediatric emergency medical care for all sick and injured children.

Back for year 9! ๐Ÿฅ‡๐Ÿ’™ Communities win when they collaborate and the JTF has always put community first!The Handtevy crew b...
01/28/2026

Back for year 9! ๐Ÿฅ‡๐Ÿ’™

Communities win when they collaborate and the JTF has always put community first!

The Handtevy crew brought the energy once again to the 2026 Whiffle Blast presented by Sports Chiropractic & Natural Health Solutions, supporting the Jason Taylor Foundation and their mission to empower South Floridaโ€™s children through health care, education, and quality of life.

Itโ€™s people like Todd Rodman, Sean Todd, and Seth Levit who bring this event to life each year for an amazing cause.

Looking forward to the 10th anniversary next year, where Dr. Antevy may get that much closer to winning the home run derby ๐Ÿ˜‚.

01/27/2026

๐—ฆ๐—ผ๐—บ๐—ฒ๐˜๐—ต๐—ถ๐—ป๐—ด ๐—ก๐—˜๐—ช ๐—ถ๐˜€ ๐˜€๐—ฐ๐—ฎ๐—ป๐—ป๐—ถ๐—ป๐—ด ๐—ถ๐—ป...๐Ÿ“ฑ๐Ÿ’ฅ
No extra devices. No workflow disruption.
Just real-time verificationโ€”all within Handtevy Mobile, stay tuned ๐Ÿš‘

Youโ€™re on scene with a trauma patient. Does your triage protocol tell you to fly them, drive them, or divert? Turns out,...
01/26/2026

Youโ€™re on scene with a trauma patient.

Does your triage protocol tell you to fly them, drive them, or divert?

Turns out, it depends on what state youโ€™re in.

A new study reviewed trauma triage protocols from 29 states with statewide EMS guidelines.
The takeaway? Wide variation in how we define trauma categories, and who goes where.

Key Findings:
โ€ข 29 of 31 states with EMS protocols include trauma triage criteria.
โ€ข Most states used 2 (52%) or 4 (31%) trauma categories, labeled by colors, numbers, or letters.
โ€ข 76% of states changed transport destination based on trauma category.
โ€ข Only 41% of states follow the latest (2021) national field triage guidelines.

Physiologic Criteria:
โ€ข 100% of states use SBP < 90 mmHg and abnormal respiratory rate as triggers.
โ€ข Only 10% use HR > 120
โ€ข Shock index >1 used in 48% of protocols.

Anatomic Criteria (nearly universal):
โžก๏ธ Penetrating trauma to head/neck/torso: 100%
โžก๏ธ Bilateral femur fractures: 90%
โžก๏ธ Amputation above wrist/ankle: 97%
โžก๏ธ Unstable pelvic fractures and flail chest: 93%

Mechanism of Injury:
โžก๏ธ Pedestrian or bicycle vs auto: 100%
โžก๏ธ MVC ejection: 97%
โžก๏ธ Death in same vehicle: 93%
โžก๏ธ Falls >10 ft: 55%, >20 ft: 38%

Patient Factors:
โžก๏ธ Older adults (65+) included in 90% of protocols
โžก๏ธ Anticoagulation considered in 86%
โžก๏ธ Pregnancy โ‰ฅ20 weeks in 79%
โžก๏ธ Only 66% use SBP

See how Handtevy Mobile eliminates tape limitations on this ๐—Ÿ๐—œ๐—ฉ๐—˜ webinar ๐—™๐—ฒ๐—ฏ๐—ฟ๐˜‚๐—ฎ๐—ฟ๐˜† ๐Ÿฐ๐˜๐—ต ๐—ฎ๐˜ ๐Ÿญ๐—ฃ๐— ๐Ÿ’ฅ Length-based tapes remain ...
01/21/2026

See how Handtevy Mobile eliminates tape limitations on this ๐—Ÿ๐—œ๐—ฉ๐—˜ webinar ๐—™๐—ฒ๐—ฏ๐—ฟ๐˜‚๐—ฎ๐—ฟ๐˜† ๐Ÿฐ๐˜๐—ต ๐—ฎ๐˜ ๐Ÿญ๐—ฃ๐— ๐Ÿ’ฅ Length-based tapes remain essential in pediatric emergency careโ€”but static dosing has limits in todayโ€™s high-acuity ED.

Join us live to explore how technology complements the length-based tape with dynamic dosing and real-time clinical decision support. ๐Ÿ“ฑ๐Ÿ’ช

Save your seat today!! ๐Ÿ‘‰ https://ow.ly/5QYW50Y0WFZ

This is our why! ๐Ÿ’™ Congratulations to the Amesbury Fire Dept. crew on their pediatric life-saving call and a special tha...
01/21/2026

This is our why! ๐Ÿ’™ Congratulations to the Amesbury Fire Dept. crew on their pediatric life-saving call and a special thanks to Acting Lieutenant TJ Poussard. We're not only honored that Handtevy Mobile was there to support them when it mattered most, but also grateful for the trust they put in Handtevy Mobile!

๐Ÿš‘ Your patient achieves ROSC โ€” the  SBP is 86 mmHg. How aggressive do you need to be?Post-ROSC hypotension is common, bu...
01/21/2026

๐Ÿš‘ Your patient achieves ROSC โ€” the SBP is 86 mmHg.

How aggressive do you need to be?

Post-ROSC hypotension is common, but this large prehospital study suggests it may be far more dangerous than weโ€™ve appreciated.

How low....and for how long... the pressure drops both matter.

๐Ÿ“Š This study analyzed 17,280 out-of-hospital cardiac arrest (OHCA) patients using national EMS data, focusing on prehospital hypotension after ROSC and its relationship to survival.

Over one-third of patients (37.8%) had at least one systolic BP < 90 mmHg after ROSC.

What they found was clear:
โžก๏ธ Higher blood pressures were consistently associated with better outcomes
โžก๏ธ Deeper and longer hypotension was associated with worse survival and more re-arrest
โžก๏ธ For every 10 mmHg increase in average SBP, the odds of survival increased by 19%.
โžก๏ธ For every 10 mmHg increase in the lowest systolic BP, survival increased by 20%.

On the flip side, increasing hypotension dose (how low ร— how long) was independently associated with:
โžก๏ธ Lower survival
โžก๏ธ Higher rearrest rates

Interestingly, patients with post-ROSC hypertension (>140 mmHg) had the highest survival rates, outperforming even normotensive patients. This challenges the traditional โ€œSBP โ‰ฅ90 mmHg is good enoughโ€ mindset.

๐Ÿšจ What about treatment?
Different hypotension management strategies (fluids, push-dose pressors, or infusions) were not associated with improved survival or faster resolution of hypotension. Vasopressor use was actually associated with higher rearrest, likely reflecting sicker patients rather than harm, but it reinforces that prevention matters more than rescue.

๐Ÿ’ก Why this matters for EMS
Post-ROSC care is not benign. Even brief or moderate hypotension may worsen secondary brain injury.

These data suggest we may need to:
โžก๏ธ Treat hypotension earlier
โžก๏ธ Avoid โ€œpermissive hypotensionโ€ post-ROSC
โžก๏ธ Reconsider whether an SBP of 90 mmHg is too low a target

๐Ÿ”‘ Bottom line:
After ROSC, depth and duration of hypotension matter. Higher systolic pressures were associated with better survival, and the traditional SBP โ‰ฅ90 mmHg threshold may be insufficient in postโ€“cardiac arrest care.

Want More? The Florida EMS Webinar has highlighted Mike Humphrey and Adam Perrett from Lethbridge Fire & EMS who have been deeply invested in this topic for some time. https://youtu.be/lObg1s06o3o

๐Ÿ“š Full study: https://ow.ly/A8Hi50Y08uT

Donโ€™t miss this ๐—Ÿ๐—œ๐—ฉ๐—˜ ๐Ÿต๐Ÿฌ-๐—บ๐—ถ๐—ป๐˜‚๐˜๐—ฒ ๐˜„๐—ฒ๐—ฏ๐—ถ๐—ป๐—ฎ๐—ฟ! ๐ŸšจDr. Peter Antevy goes ๐—ฏ๐—ฒ๐˜†๐—ผ๐—ป๐—ฑ ๐˜๐—ต๐—ฒ ๐—ด๐˜‚๐—ถ๐—ฑ๐—ฒ๐—น๐—ถ๐—ป๐—ฒ๐˜€ to break down how high-performance ...
01/20/2026

Donโ€™t miss this ๐—Ÿ๐—œ๐—ฉ๐—˜ ๐Ÿต๐Ÿฌ-๐—บ๐—ถ๐—ป๐˜‚๐˜๐—ฒ ๐˜„๐—ฒ๐—ฏ๐—ถ๐—ป๐—ฎ๐—ฟ! ๐Ÿšจ
Dr. Peter Antevy goes ๐—ฏ๐—ฒ๐˜†๐—ผ๐—ป๐—ฑ ๐˜๐—ต๐—ฒ ๐—ด๐˜‚๐—ถ๐—ฑ๐—ฒ๐—น๐—ถ๐—ป๐—ฒ๐˜€ to break down how high-performance EMS systems engineer pediatric CPR that works under real-world pressure.๐Ÿซ€

From measuring what matters to designing CPR choreography, team roles, and feedback using real EMS dataโ€”this session shows how agencies move from knowing the guidelines to owning their outcomes.

๐ŸŽ“ ๐Ÿญ ๐—™๐—ฟ๐—ฒ๐—ฒ ๐—–๐—˜ ๐—ฎ๐˜ƒ๐—ฎ๐—ถ๐—น๐—ฎ๐—ฏ๐—น๐—ฒ
Save your seat today! ๐Ÿ‘‰ https://ow.ly/gO1P50Y0f6a

You suspect a large vessel occlusion stroke, and your patient may need a thrombectomy. ๐’๐ก๐จ๐ฎ๐ฅ๐ ๐ฒ๐จ๐ฎ ๐ค๐ž๐ž๐ฉ ๐ญ๐ก๐ž ๐ก๐ž๐š๐ ๐จ๐Ÿ ๐›๐ž๐ ๐š...
01/20/2026

You suspect a large vessel occlusion stroke, and your patient may need a thrombectomy.

๐’๐ก๐จ๐ฎ๐ฅ๐ ๐ฒ๐จ๐ฎ ๐ค๐ž๐ž๐ฉ ๐ญ๐ก๐ž ๐ก๐ž๐š๐ ๐จ๐Ÿ ๐›๐ž๐ ๐š๐ญ 30ยฐ, ๐จ๐ซ ๐ฅ๐š๐ฒ ๐ญ๐ก๐ž๐ฆ ๐Ÿ๐ฅ๐š๐ญ

For years, 30ยฐ elevation has been standard for stroke patients. A new trial suggests this may actually cause harm in large vessel occlusion (LVO) patients awaiting thrombectomy.

Enter......๐“๐ก๐ž ๐™๐Ž๐ƒ๐ˆ๐€๐‚ ๐“๐ซ๐ข๐š๐ฅ (๐˜‘๐˜ˆ๐˜”๐˜ˆ ๐˜•๐˜ฆ๐˜ถ๐˜ณ๐˜ฐ๐˜ญ๐˜ฐ๐˜จ๐˜บ, 2025)

โœ… 92 LVO stroke patients randomized to flat (0ยฐ) vs elevated (30ยฐ) positioning.
โœ… Neurologic exams every 10 minutes until cath lab

๐‘๐ž๐ฌ๐ฎ๐ฅ๐ญ๐ฌ:
โœฆ Neurologic deterioration: 2% (flat) vs 55% (elevated)
โ€ผ๏ธ That's a not so subtle 34-fold difference โ€ผ๏ธ
โœฆ Severe deterioration: 1 patient (flat) vs 20 patients (elevated)
โœฆ 90-day mortality: 4.4% (flat) vs 21.7% (elevated)
โœฆ No increase in pneumonia or bleeding with flat positioning

Did someone just hear the mic drop? ๐ŸŽค

๐–๐ก๐ฒ ๐ญ๐ก๐ข๐ฌ ๐ฆ๐š๐ญ๐ญ๐ž๐ซ๐ฌ:
โœฆ 75% of patients arrived with heads already elevated โš ๏ธ
โœฆ Head position may significantly impact stability during transport delays
โœฆ Flat positioning preserves blood flow to at-risk brain tissue

๐๐จ๐ญ๐ญ๐จ๐ฆ ๐ฅ๐ข๐ง๐ž:
Flat positioning for LVO patients awaiting thrombectomy is safe, prevents deterioration, and may reduce mortality.

๐“๐ก๐ข๐ฌ ๐ข๐ฌ ๐š ๐ณ๐ž๐ซ๐จ-๐œ๐จ๐ฌ๐ญ ๐ข๐ง๐ญ๐ž๐ซ๐ฏ๐ž๐ง๐ญ๐ข๐จ๐ง ๐ฐ๐จ๐ซ๐ญ๐ก ๐ข๐ฆ๐ฉ๐ฅ๐ž๐ฆ๐ž๐ง๐ญ๐ข๐ง๐  ๐ง๐จ๐ฐ.

๐Ÿ“š Full study:https://www.handtevy.com/wp-content/uploads/2025/11/2025-JAMA-Head-of-Bed-Positioning.pdf

๐—ง๐—ฒ๐—ฎ๐—บ ๐— ๐—ฒ๐—บ๐—ฏ๐—ฒ๐—ฟ ๐—ฆ๐—ฝ๐—ผ๐˜๐—น๐—ถ๐—ด๐—ต๐˜ Time ๐Ÿ’ฅThis month, weโ€™re shining the spotlight on Dana Hunnewell, our Clinical Support Specialist, ...
01/16/2026

๐—ง๐—ฒ๐—ฎ๐—บ ๐— ๐—ฒ๐—บ๐—ฏ๐—ฒ๐—ฟ ๐—ฆ๐—ฝ๐—ผ๐˜๐—น๐—ถ๐—ด๐—ต๐˜ Time ๐Ÿ’ฅ
This month, weโ€™re shining the spotlight on Dana Hunnewell, our Clinical Support Specialist, and one of the many steady forces behind the scenes who keeps things moving forward at Handtevy HQ.

๐—ช๐—ต๐˜† ๐——๐—ฎ๐—ป๐—ฎ ๐—ฆ๐˜๐—ฎ๐—ป๐—ฑ๐˜€ ๐—ข๐˜‚๐˜ ๐ŸŒŸ
Dana brings a thoughtful, detail-driven approach to everything he doesโ€”delivering clear insights, meaningful progress updates, and consistently going above and beyond to support the team. And sometimes you'll catch his subtle sense of humor along the way!

๐—™๐˜‚๐—ป ๐—™๐—ฎ๐—ฐ๐˜!
Dana worked as a Critical Care Paramedic in Qatar and enjoys hunting, fishing and photography ๐Ÿ“ธ๐ŸŽฃ

A police officer is shot and alone. Can they get a tourniquet on themselves before losing consciousness? Turns out...may...
01/15/2026

A police officer is shot and alone.

Can they get a tourniquet on themselves before losing consciousness?

Turns out...maybe not.

A new study simulated hemorrhagic shock in law enforcement officers to see if they could successfully self-apply a tourniquet under real physiologic stress.

These were trained officers wearing full tactical gear, using standard CATs, in a controlled environment. The results werenโ€™t encouraging.

Under normal conditions, 10 out of 12 officers successfully applied the tourniquet. But under simulated hypovolemic shockโ€”mimicking blood loss from major traumaโ€”that number dropped to 8 out of 12. One officer passed out before completing the application. Another developed presyncopal symptoms.

All failures were due to inadequate tightening, not incorrect placement. And while average application time didnโ€™t change much (around 30 seconds in both conditions), it became clear that physiological stress (low blood pressure, increased heart and respiratory rates, dizziness, paresthesia) had a meaningful impact on success.

Interestingly, officers from tactical units (like SWAT) generally performed better, likely due to frequent high-stress training. Patrol officers had more difficulty.

So why does this matter for EMS? Because weโ€™re often the next link in the chain...or the only one.

These findings support a push for more realistic, stress-based TQ training for LEOs, especially solo officers. This is something worth bringing up at your next joint training day or during Stop the Bleed refreshers.

Bottom line: even a well-trained officer may struggle to apply a TQ under stress. EMS should be aware, ready to assist, and advocate for better prep on the law enforcement side.

Read the full study here:
https://www.handtevy.com/wp-content/uploads/2025/11/Evaluating-Tourniquet-Application-in-Law-Enforcement-Officers-During-Simulated-Hemorrhagic-Shock.pdf

Youโ€™re working a cardiac arrest and your agency just rolled out ultrasound.What scans are actually being used in the fie...
01/13/2026

Youโ€™re working a cardiac arrest and your agency just rolled out ultrasound.

What scans are actually being used in the field?

A new study systematically reviewed 514 EMS protocols across the U.S. to find out how prehospital ultrasound (PHUS) is actually being used, and by whom.

Hereโ€™s what they found ๐Ÿ“Š
โ€ข 657 EMS protocols were evaluated; 514 were included in final analysis
โ€ข 90 protocols (17.5%) included PHUS with defined indications
โ€ข In 93.3% of those, ultrasound is in regular use (not just pilot studies)
โ€ข 57.8% of protocols required paramedics as the minimum level for use
โ€ข 16.7% didnโ€™t specify who could use it

Top Indications for Prehospital Ultrasound:
โžก๏ธ Cardiac Arrest (75.6%)
โžก๏ธ Cardiac activity evaluation: 86.8%
โžก๏ธ Doppler pulse checks: 16.2%
โžก๏ธ Trauma (56.7%)
โžก๏ธ EFAST exam: 76.5%
โžก๏ธ Dyspnea (36.7%)
โžก๏ธ B-line assessment: 72.7%
โžก๏ธ Lung sliding: 66.7%
โžก๏ธ Procedural Guidance (36.7%)
โžก๏ธ Peripheral IV access: 69.7%
โžก๏ธ ETT confirmation: 27.3%

Other rare uses included:
โ€ข Pericardiocentesis
โ€ข Intracranial pressure screening
โ€ข Gastric tube placement
โ€ข Confirmation of deceased on arrival
โ€ข Neonatal vessel sizing

TBH that list surprised us!

So what does this mean for EMS?

While clinical outcome data is still limited, PHUS is being adopted in a wide range of systems. Itโ€™s being used to:
โ€ข Support termination decisions in cardiac arrest
โ€ข Guide procedures like IVs and intubation
โ€ข Speed up trauma triage and surgical access (with studies showing FAST may reduce time to OR by 15โ€“20 minutes)
โ€ข Lung ultrasound also shows promise for earlier heart failure diagnosis and treatment, even in systems with short transport times.

Takeaway:
Prehospital ultrasound isnโ€™t the future. Itโ€™s already here.

Are you ready?

Read the full study:https://www.handtevy.com/wp-content/uploads/2025/11/Current-Practices-in-Prehospital-Ultrasound-A-Systematic-Evaluation-of-Prehospital-Protocols-Within-the-United-States.pdf

You just presented your abstract at NAEMSPโ€ฆ now what?Does your work actually make it to publication?Letโ€™s start with a q...
01/12/2026

You just presented your abstract at NAEMSPโ€ฆ now what?

Does your work actually make it to publication?

Letโ€™s start with a quick reset on what an abstract really is in academic medicine.

An abstract is not a finished study. Itโ€™s a snapshot.

For example, one of Dr. Antevyโ€™s recent projects evaluates the use of plasma in patients with isolated severe traumatic brain injury (TBI). Each August, NAEMSP opens its call for abstracts for presentation at the January annual conference.

By that deadline, authors submit a ~350-word summary with four sections:
โ€ข Background
โ€ข Methods
โ€ข Results
โ€ข Conclusions

These submissions are screened, not formally peer-reviewed. A committee decides whether the work is appropriate for presentation, but acceptance does not equal publication.

Once the study is fully completed, itโ€™s up to the authors to:
โžก๏ธ write the full manuscript
โžก๏ธ submit it to a journal
โžก๏ธ navigate peer review

And hereโ€™s the key point:

๐Ÿ‘‰ Many abstracts never make it that far.

That's what the paper we reviewed today is all about.

๐Ÿ“Š Letโ€™s talk numbers.
This study analyzed all abstracts presented at the NAEMSP Scientific Sessions from 2018โ€“2022 to see how many ultimately became peer-reviewed publications.

Hereโ€™s what they found:

๐Ÿ“Œ Key Findings
โ€ข 1,010 abstracts analyzed
โ€ข Only 34% (348) were published in a PubMed-indexed journal within 2 years

๐Ÿ“Œ Presentation type mattered
โ€ข 47% of oral presentations were published
โ€ข Compared with 32% of poster presentations

๐Ÿ“Œ Most common journals
โ€ข Prehospital Emergency Care (143)
โ€ข Resuscitation (63)
โ€ข American Journal of Emergency Medicine (34)

๐Ÿ“Œ No meaningful improvement over time
โ€ข 2018: 29% published
โ€ข 2022: 39% published
(p = 0.137)

Additional insights:
โ€ข Median time from presentation to publication: 9 months
โ€ข First-author consistency ranged from 64โ€“86%
โ€ข Excellent agreement identifying publications (Cohenโ€™s ฮบ = 0.88)

So whatโ€™s the takeaway?
โœ… NAEMSP continues to grow. Abstract submissions continue to increase.
โ‡๏ธ But the percentage that actually becomes published science hasnโ€™t meaningfully improved in over 20 years. If we want a stronger evidence base for EMS medicine, this matters.

๐Ÿ“ฃ Final Thought
Your abstract isnโ€™t the finish line, itโ€™s the starting point.

If we want EMS to advance, we need:
โ€ข mentorship
โ€ข protected time
โ€ข institutional support
โ€ข and a culture that values publication, not just presentation

Because science that isnโ€™t published canโ€™t change practice.

๐Ÿ”— Full study:https://www.handtevy.com/wp-content/uploads/2025/11/From-Conference-Presentation-to-Publication-An-Analysis-of-Abstracts-Presented-at-NAEMSP-Scientific-Sessions-2018-2022.pdf

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