Seizing child recieving IN treatmentTherapeutic Intranasal Drug Delivery

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Intranasal  glucagon protocol for hypoglycemia:

Indications: For use on patients with documented hypoglycemia


  1. Assess ABC’s – Airway, Breathing, Circulation
  2. For pulseless patients, proceed to ACLS guidelines
  3. If hypoxemia or apnea exists– Establish oral airway and begin bag ventilation with 100% oxygen
  4. Check finger stick blood glucose.
  5. Consider other rapidly reversible causes of coma (opiate overdose, hypoxemia)
  6. 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
If no arousal occurs after 5 minutes, proceed down standard unconscious protocol including injectable D50, naloxone, etc and secure airway if necessary.