Name of the Procedure:

Injection, Glucagon Hydrochloride, per 1 mg (J1610)

Summary

This procedure involves administering glucagon hydrochloride, a hormone, via injection to rapidly increase blood sugar levels in individuals who are experiencing severely low blood sugar (hypoglycemia).

Purpose

Glucagon injections are used to treat severe hypoglycemia, a condition where blood sugar levels drop dangerously low, which can occur in people with diabetes who take insulin or other medications that lower blood sugar. The goal is to quickly elevate blood glucose levels to a safe range to prevent symptoms like confusion, seizures, or unconsciousness.

Indications

• Severe hypoglycemia (blood sugar typically below 70 mg/dL) where the patient is unconscious or unable to take oral carbohydrates.
• Symptoms such as severe dizziness, confusion, seizures, or loss of consciousness.
• Emergency situations where rapid correction of low blood sugar is crucial.

Preparation

• The person administering the injection should ensure the patient is laying down to prevent injury if they faint.
• No special fasting or medication adjustments are required for the patient.
• Ensure you have the glucagon emergency kit readily available.

Procedure Description

1. Ensure safety: Lay the patient on their side, if unconscious, to prevent choking.
2. Preparation: Open the glucagon emergency kit containing the glucagon powder and a syringe filled with diluent.
3. Mixing: Inject the diluent into the vial containing the glucagon powder. Gently swirl to dissolve completely.
4. Drawing: Draw the appropriate dose (usually 1 mg for adults and children over 25 kg, or as prescribed by the doctor) into the syringe.
5. Injection: Administer the injection intramuscularly (IM) or subcutaneously (SC), typically in the thigh or buttocks.
6. Post-injection: Turn the patient on their side if they are not already in that position and monitor their response.
7. Follow-up: Once the patient is conscious and able to swallow, give them carbohydrates orally to prevent recurrence.

Tools and Equipment: Glucagon emergency kit, alcohol swabs, and a sterile needle and syringe. Anesthesia or Sedation: Not applicable.

Duration

The entire procedure takes approximately 5-10 minutes, but the patient should be monitored continuously until they regain consciousness and their blood sugar stabilizes.

Setting

This procedure can be performed in various settings, including at home, in a clinic, or any emergency environment.

Personnel

Typically administered by a caregiver, family member, or healthcare provider. Technical guidance by a healthcare professional may be beneficial.

Risks and Complications

• Common: Nausea, vomiting.
• Rare: Allergic reactions, injection site reactions, hypotension. Management includes symptomatic relief and immediate medical attention if severe reactions occur.

Benefits

• Rapid increase in blood sugar levels.
• Prevention of the severe consequences of hypoglycemia, including brain damage and death.
• Effects are typically noticed within minutes.

Recovery

• Post-injection, the patient should be given an oral carbohydrate source as soon as they are able to swallow.
• Monitor blood sugar levels closely for several hours following the injection.
• Follow-up with a healthcare provider is recommended to adjust any diabetes management plans if necessary.

Alternatives

• Oral glucose gels or tablets (used in less severe cases where the patient is conscious).
• Intravenous glucose administration in a hospital setting.
• Pros and cons: Oral glucose is only effective if the patient is conscious. IV glucose requires hospital resources and personnel.

Patient Experience

• The patient may feel a prick or slight discomfort at the injection site.
• Rapid improvement in symptoms of hypoglycemia.
• The patient may experience nausea following administration, which usually subsides quickly.
• Comfort measures include ensuring the patient is in a safe position and monitoring them closely for adverse reactions.