Glucagon: prehospital therapy for hypoglycemia.
OBJECTIVE
This study evaluated the efficacy of glucagon for prehospital therapy of hypoglycemia in patients without IV access.


METHODS
Prospective clinical trial.


METHODS
Prehospital in a busy, urban emergency medical services system.


METHODS
Fifty consecutive patients presenting with documented hypoglycemia (ChemStrip BG less than or equal to 80 mg/dL) and symptoms of decreased level of consciousness, syncope, or seizure were enrolled.


RESULTS
Data collected included pretreatment (ChemStrip BG) and post-treatment serum glucose (hospital assay) as well as assessment of level of consciousness by a quantitative measure, the Glasgow Coma Score, and by a qualitative scale (0 to 3). The mean pretreatment blood glucose of 33.2 +/- 23.3 mg/dL increased after treatment to 133.3 +/- 57.3 mg/dL. Qualitative level of consciousness increased from a mean of 1.26 +/- .96 to 2.42 +/- .94 and Glasgow Coma Score increased from a mean of 9.0 +/- 4.19 to 13.04 +/- 3.68. The mean time until response was 8.8 minutes in those who responded to both level of consciousness criteria 82% (41 of 50). Glucagon administered for hypoglycemia resulted in a glucose increase in 98% (49 of 50) with headache as the only side effect noted in 4% (two of 50) of patients (P less than .0001).


CONCLUSIONS
Glucagon is safe and effective therapy for hypoglycemia in the prehospital setting.
Vukmir
R B
RB
Affiliated Residency in Emergency Medicine, University of Pittsburgh, Pennsylvania 15213.
Paris
P M
PM
Yealy
D M
DM
D001786:Blood Glucose / Q000032:analysis; D004632:Emergency Medical Services; D015600:Glasgow Coma Scale; D005934:Glucagon / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006261:Headache / Q000139:chemically induced; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D007273:Injections, Intramuscular; D007279:Injections, Subcutaneous; D011446:Prospective Studies; D014474:Unconsciousness / Q000209:etiology
D001786:Blood Glucose; D005934:Glucagon