Underutilization of Glucagon in the Prehospital Setting
Authors: Robert A. Gabbay, Peter A. Kahn, Nicole E. Wagner
Journal: Annals of Internal Medicine (2018)

Letters18 September 2018Underutilization of Glucagon in the Prehospital SettingRobert A. Gabbay, MD, PhD, Peter A. Kahn, MD, MPH, and Nicole E. Wagner, BARobert A. Gabbay, MD, PhDJoslin Diabetes Center and Harvard Medical School, Boston, Massachusetts (R.A.G.), Peter A. Kahn, MD, MPHYale School of Medicine, New Haven, Connecticut (P.A.K.), and Nicole E. Wagner, BAJoslin Diabetes Center, Boston, Massachusetts (N.E.W.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0300 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Although the precise makeup of nationwide EMS crews is unknown and varies by location and daily staffing requirements, the number of EMTs substantially outweighs the relatively few paramedics nationwide. Even if every ambulance was assigned 1 paramedic for every EMT, countless EMTs would still be left without paramedic partners. Without clear data from each agency, fully assessing crew composition and the makeup of each response team—which, again, varies by region—is impossible. Regardless, EMTs should still be able to administer glucagon even when paramedics are present. Emergency medical technicians can already administer certain injectable medications, such as EpiPens (Mylan) ...References1. Gunning RR, Garber AJ. Bioactivity of instant glucose. Failure of absorption through oral mucosa. JAMA. 1978;240:1611-2. [PMID: 691147] CrossrefMedlineGoogle Scholar2. Cryer PE, Hirsch IB, Mulder JE. Management of hypoglycemia during treatment of diabetes mellitus. UpToDate. Updated 9 November 2016. Accessed at www.uptodate.com/contents/management-of-hypoglycemia-during-treatment-of-diabetes-mellitus on 1 June 2018. Google Scholar3. American Diabetes Association.. 6. Glycemic targets: standards of medical care in diabetes—2018. Diabetes Care. 2018;41:S55-64. [PMID: 29222377] doi:10.2337/dc18-S006 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Joslin Diabetes Center and Harvard Medical School, Boston, Massachusetts (R.A.G.)Yale School of Medicine, New Haven, Connecticut (P.A.K.)Joslin Diabetes Center, Boston, Massachusetts (N.E.W.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2222. 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 Michael E. Mullins , William H. Dribben , and Bridget Svancarek Underutilization of Glucagon in the Prehospital Setting Kimberly Pruett , Chelsea C. White IV , and Darren Braude Metrics Cited byImpact of pharmacist outreach on glucagon prescribingChallenges and Lessons Learned From a Telehealth Community Paramedicine Program for the Prevention of Hypoglycemia: Pre-Post Pilot Feasibility Study 18 September 2018Volume 169, Issue 6Page: 427-428KeywordsAllied health care professionalsDisclosureEmergency medical techniciansEpipensGlucagonGlucoseHealth careHypoglycemiaHypoglycemicsMucous membranes ePublished: 18 September 2018 Issue Published: 18 September 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...