One of the secret weapons found in the emergency department is the pediatric drug card. At Primary Children's Hospital it's a binder located in every resuscitation and trauma room. It contains all of the pediatric drugs (based on hospital concentrations and protocols). Just flip to the child's weight and you'll find all the volumes pre-calculated. No math required! I have often wished for a similar tool for our EMTs.

Last year Emergency Medical Services for Children (EMSC) had quite a bit of funding that wasn't used due to Covid-19. We asked our County Coordinators (your representatives in EMSC) and our Advisory Committee how we should spend that money. We requested they choose something they thought would benefit the entire state and improve pediatric care. These folks are EMTs, paramedics, and nurses who live in your counties. They unanimously voted for the Handtevy Mobile App.

This is the tool I have been looking for for our EMTs! It not only offers all the benefits of a pediatric drug card but it can be tailored to your agency concentrations and protocols. It also provides guidance on those protocols and takes the pressure off the pediatric call. As a bonus, it will upload directly to ImageTrend.

In partnership with Primary Children's Hospital, we are purchasing this App; it is our gift to you and we think it will change the way you treat the pediatric patient!

Pre-arrival preparation of airway, joules, and epinephrine dosing is critical to clinical success. Handtevy removes the need for complex mathematical calculations in front of mom and dad as medication dosages and drips are customized to align 100% to your protocols and displayed in volume. So go ahead . . . stay on scene, perform confidently, and save more lives.

Drips and infusions come with a high degree of complexity and anxiety. Stop the madness! Customize your drips to ensure they are mixed according to your exact specifications every time.

Do you remember this formula – Age/4 + 4 mm = internal diameter (ID)? We don’t either. Handtevy will display the size of every piece of equipment required for any sized child and turn this confidence and proficiency into results. You deserve it . . . and they do too.

This is the fastest you’ll ever document a drug, its route, and dose (in mg, mcg, etc.), drips and equipment all with a single tap! After the call, review the list and seamlessly integrate with your ePCR.

Most treatments are documented after the call, or even hours later. Handtevy Mobile integration allows all critical treatments (medications, equipment, etc.) to seamlessly flow into ePCR in real-time.

1. How is this App different from all the rest? This is not a reference book, a pediatric drug calculator, or even a communication tool. This is your agency drugs and guidelines at the bedside and it documents for you too!
   
2. Is this a digital Broselow tape? While the Broselow tape is a valuable pediatric tool, it cannot be used until you are on scene and able to measure the patient. The Handtevy Mobile App figures weight based on age and therefore allows you to prep meds and equipment on your way. The Handtevy App will have drug dosages calculated to your agency customization so it will tell you in milliliters how much drug to draw up.
3. Does Handtevy comply with PALS guidelines? Yes and the Handtevy support team will provide continuous updates as needed.
4. Will this work off-line? Yes, the tool does not require WiFi and will save information until you are able to upload to ImageTrend.
5. Will this work for adults as well as pediatric patients? Yes!
6. How does the customization work? Once EMSC makes the statewide purchase and your agency has signed our terms letter (see below), your agency leadership will receive an electronic questionnaire to help the Handtevy team begin to build your customized Handtevy App. Their clinical team of experts will then set up a virtual meeting to review and refine the selected medications, concentrations, drips, electrical, and equipment. The customization process is what makes the Handtevy System so unique and the process is very detailed.
7. What if our drugs or protocols change, will they update the App? Yes, and most updates will go live within 24 hours.
8. How do I download Handtevy Mobile to my agency's platform? The App is free to download from iTunes, Google Play, or the Window store. Whether it’s a toughbook, tablet or personal device, once the App is downloaded to the device it’s ready to use. You only need a username and password to get started (obtain this from the Handtevy Administrator at your EMS Agency).
9. How much does it cost? There is no cost to individual first responders. EMSC in partnership with Primary Children's will be purchasing the first year and customization for all Utah EMS agencies, a $29,000.00 investment. Ongoing maintenance fees after the first year will be figured based on size of the agency and how many calls they go on per year but the Handtevy team estimates $300-$1,000 per year. EMSC is looking for a year 2 commitment but after that it will be up to each agency to decide if they want to continue it. Also if this tool has the impact we think it could, EMSC may look for ways to subsidize those maintenance fees but we would need usage and data to pave the way.

Prehospital Emergency Care

Comparison of Errors Using Two Length-Based Tape Systems for Prehospital Care in Children

2014 NAEMSP Scientific Assembly

Comparison of Two Length-Based Tape Systems for Pediatric Resuscitation

EMS World

Denver Study Reports Superiority of Handtevy System in Simulation Study

Colorado Children's Hospital 2013

Errors in Pediatric Prehospital Simulation Scenarios

Poster Presentations

Confidence in Prehospital Pediatric Emergency Care Improves with the Handtevy System

Use of Fentanyl in Pediatric Trauma Patients Post Implementation of the Handtevy™ Field Guide

Comparison of a hybrid pediatric weight estimation method (HandtevyTM) to the BroselowTM length based tape

Dr. Peter Antevy, innovator of the Handtevy Pediatric Resuscitation System, is a nationally recognized lecturer and expert in the field of pre-hospital pediatrics. He is extremely passionate about improving both adult and pediatric pre-hospital care and evaluating and improving upon currently accepted medical practice. Dr. Antevy received his medical degree from the University of Miami School of Medicine in 1999 and completed his pediatric training at the Children’s Hospital of Los Angeles. He then achieved a subspecialty degree in Pediatric Emergency Medicine at the Children’s Hospital of Pittsburgh before returning to Florida where he has been a Pediatric Emergency Medicine Physician at Joe DiMaggio Children’s Hospital since 2005. Dr. Antevy also currently serves as the EMS Medical Director for Davie Fire-Rescue, Coral Springs Fire Department, Southwest Ranches Fire Rescue, and American Ambulance, and is the Associate Medical Director for Palm Beach County Fire Rescue, Miramar Fire Rescue, and Seminole Tribe Fire Rescue. Peter currently serves as the President of the Greater Broward EMS Medical Directors’ Association, an organization whose providers serve the 1.5 million residents of Broward County, Florida. For his efforts, Dr. Antevy was awarded the prestigious Raymond H. Alexander EMS Medical Director of the Year Award in 2014. He also was honored as one of the 2015 Top Ten Innovators in EMS by JEMS.

EMSC sent out a letter to all EMS agency leadership detailing our plan to distribute the Handtevy Mobile app throughout the state. The letter asks for their response and so far we have had a 50% response rate. It is not too late! Our timeline for implementation is early 2021. Encourage your agency leadership to respond. Contact our program manager BrianneGlenn@utah.gov if you need another copy of the letter.

We are asking for 3 things from each agency in relation to this gift. Each agency will:

1. Designate a PECC, a pediatric champion (detailed below) within their agency to act as a point person for EMSC and the Handtevy team.

2. Participate in EMSC surveys and data collection on the App usage when requested.

3. Consider the year 2 maintenance fee so we can give this App a "hard try."

• Our January 11 PETOS topic is Handtevy. Those in attendance will have an opportunity to use the demo and practice with the App. See events below.
• In September, Dr. Peter Antevy and EMSC held a virtual demo to introduce the App. Follow this link https://register.gotowebinar.com/recording/4248070236387080459

Winter Safety

Why Kids Shouldn’t Wear Bulky Coats in Car Seats | Today’s Parent

Climate Change is Making Winter Ice More Dangerous | New York Times

Utah's Vaccine Roll Out

Utah’s first shipment of COVID-19 vaccine arrived the week of December 14. The first vaccines were given to healthcare workers at Intermountain Healthcare and the University of Utah Health on December 15. Second doses for this group are expected to arrive next week.
Nearly 24,000 COVID-19 vaccines have been given to Utah’s hospital healthcare workers, long-term care facility residents and staff, non-hospital healthcare workers, public health and Tribal healthcare workers.
EMTs, paramedics, and EMS personnel are now eligible for vaccination. Visit the local health department where you live or work and make an appointment. Vaccines are free but you may be asked for proof of employment in one of the eligible categories.
Later in Phase 1, likely in late January, K-12 teachers and school staff will begin receiving vaccines. This coordination is happening between school district administrators and local health departments.
Phase 2 vaccinations are expected to begin as early as mid-February. Utah residents who are 75 and older will receive the vaccine first once Phase 2 vaccinations begin.

Stand as an example for community members in this fight against Covid-19

As medical providers, it is OUR responsibility to rely on evidence-based sources when gathering and sharing information about the virus. We need to be a united team and support each other and our communities in a positive way. Please work to spread truth instead of rumors. Some suggestions for evidence-based information are listed here.

• Utah Department of Health
• Center for Disease Control and Prevention
• World Health Organization (WHO)
• IntermountainHealthcare.org

Coronavirus avoidance, a few things teachers can learn from healthcare workers

The Utah Department of Health EMSC put together a training toolbox for teachers and anyone else needing instruction on use of PPE.

https://drive.google.com/drive/folders/1cJbzPOc-D0B-PI1fK-HTJUvaxG_lCAns?usp=sharing

Covid-19 Trackers

Johns Hopkins Global tracker (desktop)

Johns Hopkins Global tracker (mobile)

Utah Department of Health

The EMS for Children Survey will launch January 6, 2021 and the last day responses will be accepted is March 19, 2021. Beginning the first week of January the Utah EMSC Program will email the survey to the training officer, agency director, and the agency PECC. Only one person from each agency should complete the survey. Agencies who do not complete the survey by February can expect to receive phone calls from EMSC to assist in the survey completion. Follow this link to learn more and get started https://www.emscsurveys.org/
What's the point?
The answers to this survey help identify priorities for funding and tell us what agencies are doing well and what challenges they are facing. This survey is important and the results are used to make real decisions at the state and national level. We urge you to take 15 minutes to complete the survey when you receive it. Our staff are available to help answer questions. Please contact us for any help you might need!

Brianne Glenn, EMSC Program Manager

Brianneglenn@utah.gov

Do you have a question for our EMSC Medical Director, Hilary Hewes, MD, PCH, ER Attending Physician about this newsletter topic or anything related to pediatrics? Shoot an email to the following address tdickson@utah.gov.

Contact PCH EMS Liasion Lynsey Cooper at Lynsey.Cooper@imail.org

If you are a pediatric advocate within your agency, we need you. Please contact our program manager, Brianne Glenn (brianneglenn@utah.gov) to find out how you can help.

Pediatric Education for the Prehospital Provider

Register online at www.peppsite.com. Look up classes in Utah and find the one that works for you. Once you find the class, go to jblearning.com, and look up pepp als in the search tool. Purchase the number ($18.95). Return to peppsite.org to register for the class and follow the prompts.

If you have any questions, please email Erik Andersen at eandersen@utah.gov or text/call 435-597-7098. Continue to watch the website for additional classes.

The Emergency Medical Services for Children (EMSC) Program aims to ensure that emergency medical care for the ill and injured child or adolescent is well integrated into an emergency medical service system. We work to ensure that the system is backed by optimal resources and that the entire spectrum of emergency services (prevention, acute care, and rehabilitation) is provided to children and adolescents, no matter where they live, attend school, or travel.

Email: tdickson@utah.gov
Website: https://bemsp.utah.gov/
Phone: 801-707-3763
Facebook: facebook.com/Chirp-UtahDepartmentofHealth