Subcutaneous Glucagon May Be Better Than Oral Glucose for Prehospital Treatment of Symptomatic Hypoglycemia
- Marian J. Vermeulen12,
- Michael Klompas3,
- Joel G. Ray4,
- Chris Mazza5 and
- Laurie J. Morrison126
- 1Division of Prehospital Care, Department of Emergency Services, Sunnybrook and Women’s College Health Sciences Center, Toronto, Canada
- 2Department of Health Administration, University of Toronto, Toronto, Canada
- 3Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- 4Department of Medicine, St. Michael’s Hospital and University of Toronto, Toronto, Canada
- 5Ontario Air Ambulance Base Hospital Program, Toronto, Canada
- 6Division of Emergency Medicine, Department of Medicine, University of Toronto and Toronto Emergency Medical Services, Toronto, Canada
- Address correspondence to Marian Vermeulen, Institute for Clinical Evaluative Sciences, Sunnybrook and Women’s College Health Sciences Centre, Room G111, 2075 Bayview Ave., Toronto, Ontario M4N 3M5, Canada. E-mail: marian.vermeulen{at}ices.on.ca
The optimal management of symptomatic hypoglycemia in the prehospital setting remains uncertain, particularly in the absence of intravenous access (1,2). We performed an audit in Toronto, ON, Canada, and compared prehospital patient care outcomes following administration of oral glucose gel versus subcutaneous glucagon. For the city’s population of >2.5 million people, there is a single Emergency Medical Service system made up of both ambulance and fire services, which are directed by one base hospital.
Our study included all consecutive patients attended by primary care paramedics for symptomatic hypoglycemia, defined as a capillary glucose concentration <4.0 mmol/l (72 mg/dl). Initially, the primary care paramedics followed a …
