Underutilization of Glucagon in the Prehospital Setting
Authors: Michael E. Mullins, William H. Dribben, Bridget Svancarek
Journal: Annals of Internal Medicine (2018)

Letters18 September 2018Underutilization of Glucagon in the Prehospital SettingMichael E. Mullins, MD, William H. Dribben, MD, and Bridget Svancarek, MDMichael E. Mullins, MDWashington University School of Medicine, St. Louis, Missouri (M.E.M., W.H.D., B.S.)Search for more papers by this author, William H. Dribben, MDWashington University School of Medicine, St. Louis, Missouri (M.E.M., W.H.D., B.S.)Search for more papers by this author, and Bridget Svancarek, MDWashington University School of Medicine, St. Louis, Missouri (M.E.M., W.H.D., B.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0299 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Kahn and colleagues (1) assert that every basic EMT should carry and be able to administer intramuscular glucagon and that every patient with diabetes should have access to glucagon at home. They further assert that wider availability of glucagon would decrease the number of emergency department visits and hospital admissions, with the implicit assumption that preventing patients with diabetes who have hypoglycemic events from seeking immediate medical care is desirable.Although the proposal that EMTs should be able to administer intramuscular glucagon seems reasonable, the authors overlook that injectable medications fall outside the nationally recognized scope of ...References1. Kahn PA, Wagner NE, Gabbay RA. Underutilization of glucagon in the prehospital setting. Ann Intern Med. 2018;168:603-4. [PMID: 29277850]. doi:10.7326/M17-2222 LinkGoogle Scholar2. National Highway Traffic Safety Administration. National EMS scope of practice. 2018. Accessed at www.ems.gov/pdf/education/EMS-Education-for-the-Future-A-Systems-Approach/National_EMS_Scope_Practice_Model.pdf on 13 August 2018. Google Scholar3. McLaughlin SA, Crandall CS, McKinney PE. Octreotide: an antidote for sulfonylurea-induced hypoglycemia. Ann Emerg Med. 2000;36:133-8. [PMID: 10918104] CrossrefMedlineGoogle Scholar4. Dougherty PP, Klein-Schwartz W. Octreotide's role in the management of sulfonylurea-induced hypoglycemia. J Med Toxicol. 2010;6:199-206. [PMID: 20352540] doi:10.1007/s13181-010-0064-z CrossrefMedlineGoogle Scholar5. Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2017. Atlanta: Centers for Disease Control and Prevention; 2017. Accessed at www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf on 30 December 2017. Google Scholar Author, Article, and Disclosure InformationAffiliations: Washington University School of Medicine, St. Louis, Missouri (M.E.M., W.H.D., B.S.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L18-0299. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUnderutilization of Glucagon in the Prehospital Setting Peter A. Kahn , Nicole E. Wagner , and Robert A. Gabbay Underutilization of Glucagon in the Prehospital Setting Robert A. Gabbay , Peter A. Kahn , and Nicole E. Wagner Underutilization of Glucagon in the Prehospital Setting Kimberly Pruett , Chelsea C. White IV , and Darren Braude Metrics 18 September 2018Volume 169, Issue 6Page: 426-427KeywordsDisclosureEmergency departmentEmergency medicineFallsGlucagonGlucoseHypoglycemiaHypoglycemicsMedicarePatients ePublished: 18 September 2018 Issue Published: 18 September 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...