Limited Availability of Glucagon by Emergency Personnel

Abstract

Hypoglycemia causes more than 100,000 emergency department visits per year costing over $120 million. Glucagon can reduce the number and severity of hypoglycemic episodes requiring emergency medical attention and hospital admission. However, EMS personnel are often unable to administer glucagon. U.S. EMS offices were queried for glucagon administration and blood glucose testing protocols. Only paramedics are able to administer glucagon in most states, whereas the 198,200 EMT-Basics personnel nationally cannot. The average response time to calls was 15.34 minutes. Dispatchers correctly coded 44.67% of these calls as a “diabetic problem,” increasing the likelihood of dispatching providers who cannot administer glucagon. The National Emergency Management Information System (NEMIS) (2013- 2015) indicates 89, 263 cases in which glucagon was administered with only 3,944 events with side effects. Despite its’ favorable safety profile, glucagon cannot be administered by EMT-basics in most states, even though family members can often with minimal training. 3 out of 4 emergency personnel are unable to use glucagon. The likelihood of the correct personnel being dispatched based on dispatcher information alone is poor. Increasing the availability of glucagon in the prehospital setting will likely result in reduced cost burden and adverse consequences of severe hypoglycemia. EMS Policies Regarding Use of Glucagon and Blood Glucose Testing. Disclosure P. Kahn: None. N. Wagner: None. R.A. Gabbay: Consultant; Self; Merck Sharp & Dohme Corp.. Advisory Panel; Self; Onduo, health reveal.