A COMPARISON OF GLUCAGON AND GLUCOSE IN PREHOSPITAL HYPOGLYCEMIA

Objective-To compare intramuscular glucagon with intravenous glucose i n the prehospital management of hypoglycaemia in adults. Methods-In th e first part of the trial all UK ambulance services were asked how the ir personnel treat prehospital episodes of hypoglycaemia. In the secon d part, two protocols for treating prehospital hypoglycaemia were stud ied. In phase 1, intramuscular glucagon 1 mg was used. In phase 2, int ravenous glucose 25 g was used; if intravenous access was not possible , intramuscular glucagon was given. Results-33 out of 43 respondent am bulance services (76.7%) only use glucagon for prehospital hypoglycaem ia; the remaining services use glucose and glucagon. In the second par t of the study the median duration from diagnosis to full orientation (Glasgow coma score 15) was 28 minutes (95% confidence interval 18 to 49 minutes) in phase 1 and 11 minutes (95% confidence interval 8 to 19 minutes) in phase 2. This difference is statistically significant (P <0.005). On-scene times were not significantly different. Conclusions- Intravenous glucose is the treatment of choice in prehospital hypoglyc aemia but glucagon should also be available for intramuscular use when intravenous access is not possible.