Glucagon training help!!

Thanks so much for the response. I was thinking much the same about giving the glucagon. The question came up in a 504 meeting today & I told the mom that no, we would not test first if her son was unconscious because I wouldn't want to delay treating a possible hypoglycemic episode.

Then I get home & my husband who is a physician in the ER says they test quickly first. So I immediately questioned my thinking on it, of course. So grateful for all the experienced nursing advice on this forum!!

There are some EMT's (or former EMT's) on our quick response team that I will need to train. I don't know what their protocol is & am not sure if they will really question me on it.

I don't work in a school anymore but I have a diabetic child on my caseload who just got placed with new foster parents and the DNE taught the new foster parents to check the blood glucose before giving glucagon if he ever passes out or has a seizure.

Thanks! Maybe there are a variety of opinions on this? Still confused on how to handle it for sure....

Our lead nurse said not to check. She is on maternity leave right now & me being new, I don't want to cause a problem by asking someone else..

So I finally found on one of our glucagon information sheets that for mild symptoms of hypoglycemia that we check first, but for moderate symptoms we treat without checking. For severe symptoms just give the glucagon. So now I have it in black and white from our district's nursing documents. Maybe that will change in the future....

As the mother of a rather brittle diabetic, the answer is if the kid appears severely hypoglycemic, go ahead and give the glucagon (if the kid isn't coherent enough to try a glucose pill or the old maple syrup trick). Severe hypoglycemia is an "time is of the essence" condition. DKA is typically not. Even if the kid is in DKA or way high on his bg, the glucagon isn't going to hurt him. If the kid was hypoglycemic, this should bring him around. If not, you're going to have to 911 him anyhow (either hypoglycemic or DKA). You can do a bg test while you're waiting for the ambulance.

Also understand that glucagon is a last ditch, one shot. So you need to either get glucose into the kid by mouth (if he's conscious) or get the IV going, so my policy is to 911 even when I'm giving glucagon. (We don't have D50 in our clinics, and I'm not authorized to give it even if we did).

Since glucagon takes 10 - 15 minutes to take effect, I push for only giving it if a kiddo can't take oral quick-acting carbs. If the child is unresponsive or seizing, (just try to get a fingerstick on a seizing child BTW ) I'm not waiting to test. I'll give the shot and call 911.

Thank you!!!

Thank You!!

interesting, colleague of mine went through same thing

When I was an Army Nurse in Massachusetts to earn extra monies I worked part time at Joslins Diabetic Hospital. The off shoots from this hospital in some areas of the countries is called Humphries (in the northwest). I am only 2 family members on my fathers side that does not have diabetes. I had 2 aunties and numerous cousins. All have been diagnosed at an early age (around 2 years old). My father bless his heart died form Diabetes complication when he was only 42. He did not take care of himself very well.

I think it is a good ideal to check I would, just for the reason your hubby says.

Additionally I would give all students and parents the following email website for Diabetes ongoing questions and to learn more about the disease:

Pediatric Diabetes Services | Joslin Diabetes Center

I have given Joslins numerous tissue/blood samples as well as most of my cousins and aunties. Hopefully one day there will be a cure for this disease.

One of the issues my husband has brought up is that there are so many different glucometers that it would be hard to know how to quickly use them all--especially if it's not something you are routinely doing. Because that could slow down the administration of the glucagon & because my supervisor said don't test, I am going to train them to just give it if the student is symptomatic and unable to swallow something. I hope that when our lead nurse returns from maternity leave I could ask her to write a policy on it. I have 2 different glucagon information sheets that I got off of our shared drives that each say something different. One says test if possible; the other has it underlined "do not test."

I think asking for a policy on it would help me feel more comfortable one way or another. My husband says it is quite possible to have different doctors who would feel differently on the subject. Maybe I am worrying too much or splitting hairs, but I'd like to see a policy on it. Thanks for all the comments friends!!