• R B Vukmir, P M Paris, and D M Yealy.
• Affiliated Residency in Emergency Medicine, University of Pittsburgh, Pennsylvania 15213.
• Ann Emerg Med. 1991 Apr 1;20(4):375-9.

Study ObjectiveThis study evaluated the efficacy of glucagon for prehospital therapy of hypoglycemia in patients without IV access.DesignProspective clinical trial.SettingPrehospital in a busy, urban emergency medical services system.Type Of ParticipantsFifty consecutive patients presenting with documented hypoglycemia (ChemStrip BG less than or equal to 80 mg/dL) and symptoms of decreased level of consciousness, syncope, or seizure were enrolled.Measures And Main ResultsData collected included pretreatment (ChemStrip BG) and post-treatment serum glucose (hospital assay) as well as assessment of level of consciousness by a quantitative measure, the Glasgow Coma Score, and by a qualitative scale (0 to 3). The mean pretreatment blood glucose of 33.2 +/- 23.3 mg/dL increased after treatment to 133.3 +/- 57.3 mg/dL. Qualitative level of consciousness increased from a mean of 1.26 +/- .96 to 2.42 +/- .94 and Glasgow Coma Score increased from a mean of 9.0 +/- 4.19 to 13.04 +/- 3.68. The mean time until response was 8.8 minutes in those who responded to both level of consciousness criteria 82% (41 of 50). Glucagon administered for hypoglycemia resulted in a glucose increase in 98% (49 of 50) with headache as the only side effect noted in 4% (two of 50) of patients (P less than .0001).ConclusionGlucagon is safe and effective therapy for hypoglycemia in the prehospital setting.

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