Intranasal glucagon protocol for hypoglycemia:
Indications: For use on patients with documented hypoglycemia
- Assess ABC’s – Airway, Breathing, Circulation
- For pulseless patients, proceed to ACLS guidelines
- If hypoxemia or apnea exists– Establish oral airway and begin bag ventilation with 100% oxygen
- Check finger stick blood glucose.
- Consider other rapidly reversible causes of coma (opiate overdose, hypoxemia)
- If hypoglycemia is documented by finger stick blood glucose, continue as below:
- Solubilize 2 mg of glucagon (2 vials) in a total volume of 1 ml of diluent (1/2 ml per vial). If possible obtain sodium glycocholate as the diluent, if not use that which comes with the package.
- Load syringe with 2 mg of glucagon and attach a nasal atomizer.
- Place atomizer within the nostril
- Briskly compress syringe to administer 1/2 of atomized spray.
- Remove and repeat in other nostril, so the entire 2 mg of medication are administered.
- Simultaneously administer glucose paste under lip and tongue to further enhance blood sugar elevation.
- Continue ventilating patient as needed