Glucagon without an IV

[crotchitymedic1986]

be thankful that i would know how to save your life, while the others watch you circle the drain

[sirduke]

Crotch, if I saw you coming I'd probably take my own life to avoid the shame. This diabetic will keep close reign on his blood sugar...

[crotchitymedic1986]

i would probably opt for an inch and 1/2 line off the fire truck for you --- but instead of D50, I would administer Jack Daniels

[mobey]

Should have read the whole thread before I responded.

DELETED

[Arizonaffcep]

Here is something else to think about...glucagon (intended for use when you can't get an IV--to be used as a stop-gap), but keep in mind that it is also a smooth muscle relaxant...which means, if at first you can't get the IV, give it, and if pt's still down for the count...look again for an IV...you will probably find something that wasn't there...

[JakeEMTP]

Here is something else to think about...glucagon (intended for use when you can't get an IV--to be used as a stop-gap), but keep in mind that it is also a smooth muscle relaxant...which means, if at first you can't get the IV, give it, and if pt's still down for the count...look again for an IV...you will probably find something that wasn't there...

Agreed. We have a FF that we go to for hypoglycemia. He's a fighter when his sugar get's low so for the safety of me, my partner and the pt. he gets glucagon 9 times out of 10 before D50.

[Rescue0ne]

I wasn't aware that some Ontario PCP's where not allowed IV access...

I realize I don't understand the way things are done in Canada...but for a provider to be a "Paramedic", and not be allowed to initiate IV therapy? Is PCP the same as an EMT-B? I realize this is sort of off-topic, but I'm really curious.

[rock_shoes]

I realize I don't understand the way things are done in Canada...but for a provider to be a "Paramedic", and not be allowed to initiate IV therapy? Is PCP the same as an EMT-B? I realize this is sort of off-topic, but I'm really curious.

In Canada we use three levels that are referred to as paramedics. Primary Care Paramedics (PCP's) have a roughly the same scope of practise as an EMT-I and have at minimum finished a program equivalent to 33 university credits (the equivalent of 2 semesters full time at a Canadian university). Advanced Care Paramedics(ACP's) are equivalent in scope and in some cases beyond in scope to EMT-P. ACP's have finished at minimum 93 university level credits (the equivalent of 6 semesters or 3 years in a Canadian university full time). Critical Care Paramedic's (CCP's) scope of practise is in a state of flux as this is a relatively new level of care. CCP's must first be ACP's and then attend a recognized CCP program. CCP programs include large portions of critical care nursing and respiratory therapy (including transport ventilators ect.). In my experience CCP's are used much like a PA specialized in emergency and transport medicine.

[rock_shoes]

PCP's without IV, at least in BC, are the remains of a flopped program called Paramedic 1.

[hertzvanrental]

I find this an interesting topic. Here in the UK as you know we have EMT and Paramedic. EMTs give glucose gel & I.M glugagen, Paramedics have I.V glucose as well. Now when I was an EMT and working with another EMT or if I was working solo on a response car my only options were glucagen if a/w was compromised. The vast majority of diabetic hypos that I attended all stayed at home after glucagen and some oral sugars & carbs. Never had any problems. Obviously I.V glucose is preferable and that is what I give now. Nearly all our hypos are treated and left at home (IV taken out of course) again never had any problems.

Someone made a comment about not getting an IV, giving glucagen and then having another look for an IV coz they may have better luck, this is because glucagon is an inatrope therefore raising BP= good veins (sometimes anyway).

Our guidelines state that it's a clinical decision as to whether a paramedic chooses to give glucagen or IV glucose. Like I said before I go for IV every time.

Rectal, errrr yuck! I will be getting my EZ-IO out before ever considering administering via the brown route! Sticky, sugary ass, fuck that!