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Prehospital Intranasal Glucagon for Hypoglycemia
Ameera Haamid1, Errick Christian1, Katie Tataris2
1Department of Emergency Medicine, Cook County Health, Chicago, Illinois.
Prehospital Emergency Care
|February 24, 2022
Summary
Intranasal glucagon effectively treats prehospital hypoglycemia, improving mental status and blood glucose levels. This method offers a safer alternative to injections, reducing needle-stick injuries for paramedics.
Area of Science:
- Emergency Medicine
- Pharmacology
- Prehospital Care
Background:
- Prehospital hypoglycemia is typically managed with oral or intravenous dextrose.
- Intramuscular glucagon is an alternative when vascular access is unavailable.
- Occupational needle-stick injuries are a significant risk with injectable medications in prehospital settings.
Purpose of the Study:
- To evaluate the efficacy of intranasal (IN) glucagon in treating prehospital hypoglycemia.
- To assess the impact of IN glucagon on patient mental status and blood glucose levels.
Main Methods:
- Retrospective analysis of consecutive cases using IN glucagon by paramedics (January 2015 - December 2020).
- Included cases had documented pre- and post-administration blood glucose levels and no other hypoglycemia treatments.
- Primary outcome was paramedic-documented clinical response; secondary outcomes were blood glucose changes.
Main Results:
- Of 44 cases, 32% showed substantial improvement, 30% slight improvement, and 38% no improvement in mental status.
- Substantial improvement cases saw a mean blood glucose increase from 33.8 to 87.1 mg/dL.
- Slight improvement cases had a mean blood glucose increase from 23.9 to 53.8 mg/dL.
Conclusions:
- Intranasal administration of recombinant glucagon is effective for hypoglycemia in select prehospital cases.
- IN glucagon led to clinically significant improvements in mental status and blood glucose levels.
- This route may offer a safer alternative to injections, reducing occupational hazards.
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