When To Use Glucagon IN

[uglyEMT]

OK I have been reading on threads that it is now standard protocol to use Glucagon IN. Apparently it is cutting edge but I can't find any literature on this. Can anyone help me?

[chbare]

I'm not sure we really need to continue making threads that mirror an already derailed and inflammatory thread?

Take care,

chbare.

[uglyEMT]

You are right. I guess I was punchy this AM.

Mods you can delete as necessary

[mobey]

Google is your friend.

http://intranasal.net/glucagon/glucagonabstracts.htm

http://www.ncbi.nlm.nih.gov/pubmed/8243872

http://care.diabetesjournals.org/content/12/9/604.abstract

[DwayneEMTP]

Google is your friend.

http://intranasal.ne...onabstracts.htm

http://www.ncbi.nlm..../pubmed/8243872

http://care.diabetes.../9/604.abstract

Actually, I think that this is a great idea for a thread. Google does seem to be your friend in this case if what you're looking for is 20-30 year old information, and I'm not, as I'm guessing Ugly isn't either.

I've not found any current data. And before you say, "well, that's because they studied the shit out of it 20 years ago!" tell me why it isn't the standard of care now? Just breezing through some of those links is sounds as if it possibly has a slightly earlier onset, doesn't tend to dump all of the Glycogen stores creating hyperglycemia as the IM delivery tends to do (or so some of those articles claim) which should make in hospital management at least a little bit easier, has a less intrusive delivery system, and pediatrics reported less N/V post delivery. (Information gleened from one or more of the links provided by Mobey above.)

So why isn't it the standard of care everywhere?

Dwayne

Edited to site Mobeys links as gross sources.

Edited April 6, 2011 by DwayneEMTP

[tcripp]

So why isn't it the standard of care everywhere?

Glucagon is used by several services in my area with IN as an accepted route. It's rate of absorption is equal to or faster than that of IM not to mention, why stick the patient one more time if you don't have to.

Now, I do not have the data to back it up other than the fact that I can find, online, other services who do administer it that way.

But...to your question posed (as quoted above). I'd like to answer your question with a question. Why isn't IN administration a standard everywhere? There are just some medical directors who aren't comfortable with this particular item and since we require their "okey dokey" to practice, we do what they want. That holds to many other treatments as well.

My service does not have IN as an option and that includes Versed to help sedate a combative patient. Regardless, if I can't get an IV for Valium (...um, needle near a comabtive patient), then my next alternative is Versed IM (yet another needle near a combative patient).

Just because it's not accepted EVERYWHERE doesn't mean it is necessarily a bad thing.

***Ugly, thanks for starting this thread. I started to yesterday and then got distracted by bright, shiney things.

[mobey]

Damn..... didn't look at dates

[uglyEMT]

Wow I started it as a ha ha but I guess I inadvertantly started something good

I will try and see what my areas ALS protocols are. Being I am a basic the olny needle I get to use is Epi Pens.

[NYCEMS9115]

It has been research and in use overseas.

www.intranasal.net

[crotchitymedic1986]

The answer probably has something to do with the costs. IM Glucagon use to cost around $80-100.00 per dose, I imagine "IN" is very expensive, but do not know for sure.