Glucagon is a naturally occurring hormone that regulates blood glucose levels within the body. The emergency glucagon kit contains a synthetic version designed to act as a rapid counter-regulatory measure against dangerously low blood sugar, a condition known as severe hypoglycemia. When administered, glucagon signals the liver to release its stored glucose (glycogen) into the bloodstream, quickly elevating the patient’s blood sugar concentration. This quick-acting intervention is specifically reserved for situations where a person experiencing a severe low cannot safely treat themselves with oral sources of sugar. The kit serves as a life-saving tool for people with diabetes who use insulin or certain other medications that increase the risk of severe blood sugar drops.
Recognizing the Need for Emergency Glucagon
The decision to administer emergency glucagon rests on distinguishing between mild or moderate hypoglycemia and a truly severe event. Mild lows, characterized by symptoms such as shakiness, sweating, and rapid heart rate, can typically be treated by consuming 15 grams of fast-acting carbohydrate, like juice or glucose tablets. In contrast, severe hypoglycemia is an emergency defined by neurological impairment that makes self-treatment impossible, usually when blood glucose levels fall below 54 mg/dL. The primary indicators that necessitate the use of an emergency kit are the patient’s inability to safely swallow or a complete loss of consciousness.
If a person is extremely confused, disoriented, or exhibiting seizure activity, they must not be given anything by mouth due to the high risk of choking or aspiration. Seizures and unconsciousness represent the most extreme manifestations of severe hypoglycemia and demand immediate glucagon administration. Furthermore, if the individual is simply unwilling or unable to follow commands to consume oral sugar, the emergency treatment should be initiated. The emergency kit is a tool for caregivers, family members, or bystanders to use when the patient is incapacitated and requires external intervention to prevent a medical catastrophe.
The goal of this intervention is to restore the patient’s mental function enough so they can safely take oral carbohydrates and stabilize their blood sugar. Because the glucagon acts on glycogen reserves in the liver, its effectiveness can be limited in individuals who have been fasting for a long time or have certain liver conditions. Therefore, recognizing the specific signs of severe impairment is the sole trigger for deploying this powerful hormone.
Step-by-Step Glucagon Administration
Emergency glucagon is available in several formats, including the traditional powder-and-liquid kit, pre-mixed autoinjectors, and nasal powder devices. The traditional kit requires a mixing step immediately before use, involving injecting the liquid solvent from the pre-filled syringe into the vial containing the powdered glucagon. The vial must then be gently shaken or rolled until the powder is fully dissolved and the solution is clear.
Once mixed, the solution is drawn back into the syringe, and the injection is delivered into a large muscle, such as the upper arm, thigh, or outer buttock. The needle should be inserted at a 90-degree angle, and the entire dose should be administered quickly into the muscle tissue. Modern autoinjector devices simplify this process, as they contain a pre-mixed, stable liquid formulation and require only the removal of a cap before pressing the injector firmly against the skin for a few seconds.
The nasal powder formulation offers a needle-free alternative, where the device is inserted gently into one nostril. Administration is straightforward: the plunger is pressed firmly until the dose is delivered. The medication is absorbed through the nasal membranes and does not need to be inhaled by the patient to be effective. Regardless of the device type used, immediate administration is prioritized, and there is no harm in injecting the medicine through clothing.
Action Protocol Following Emergency Use
Immediately after administering the glucagon, the patient must be turned onto their side, known as the recovery position. This step is important because a common side effect of glucagon, or severe hypoglycemia itself, is vomiting. Positioning the person on their side prevents them from choking on vomit or other secretions while their consciousness returns.
Call for emergency medical services (EMS) or 911 following any severe hypoglycemic episode treated with emergency glucagon. While glucagon works rapidly, often causing the patient to wake up within 10 to 15 minutes, medical assessment is still necessary. If the patient does not regain consciousness within 15 minutes of the first dose, a second dose may be given, if available, while waiting for the ambulance.
Once the patient is awake and capable of swallowing, they must consume a fast-acting source of carbohydrate, such as juice, soda, or glucose gel. This immediate sugar intake helps replenish the blood glucose that the glucagon mobilized from the liver. Following this, the patient should consume a long-acting carbohydrate, like crackers and cheese or half a sandwich, to prevent the blood sugar from dropping again. The healthcare provider who manages the patient’s diabetes should be informed of the severe episode to review and adjust the treatment plan.