Glucagon is a hormone that manages severe low blood sugar, or hypoglycemia. This medication helps the liver release stored sugar into the bloodstream, rapidly increasing blood glucose levels. Knowing how and where to administer glucagon is important for emergency care in severe hypoglycemia.
Recommended Injection Sites
Glucagon is designed for intramuscular (IM) injection, meaning it needs to be delivered directly into a muscle. Large muscles allow for quick absorption of the medication into the bloodstream. The most commonly recommended sites for injecting glucagon include the outer thigh, the upper arm, and the buttock.
The thigh is a frequently used site, specifically the vastus lateralis muscle on the outer upper leg. To locate this area, divide the thigh from the hip to the knee into three sections; the middle outer section is suitable. This site has a large muscle mass, making it a reliable choice.
Another suitable location is the deltoid muscle in the upper arm. This muscle is large and easily exposed. For situations where the thigh or arm might be inaccessible, the upper outer quadrant of the buttock, specifically the gluteal muscle, serves as an alternative. These sites are chosen for their substantial muscle tissue, which facilitates effective delivery and absorption.
Administering Glucagon
Administering glucagon involves several steps for correct preparation and delivery. Many emergency kits contain a vial of dry powder glucagon and a pre-filled syringe of sterile water for mixing. Before injection, check the expiration date and ensure the powder is completely dissolved. The solution should appear clear and colorless.
To prepare, remove the cap from the glucagon vial and the needle cover from the syringe. Inject the sterile water into the powder vial. With the needle still in the vial, gently shake or swirl until the powder dissolves and the solution is clear. Draw the mixed solution back into the syringe, ensuring no large air bubbles remain.
Once prepared, select one of the recommended injection sites, such as the outer thigh or upper arm. Pinch the skin at the chosen site. Insert the needle into the skin at a 90-degree angle into the muscle, then depress the plunger completely to inject all medication. After injection, pull the needle straight out and apply light pressure to the injection site. Proper disposal of the used syringe and needle in a sharps container prevents accidental sticks.
Post-Injection Care and Follow-Up
After administering glucagon, continuously monitor the person’s response. The individual should begin to regain consciousness within 15 minutes. Turning the person onto their side is recommended, as glucagon can cause nausea and vomiting, and this position helps prevent choking.
Once alert and able to swallow, provide a fast-acting sugar source, such as fruit juice or glucose tablets. Follow this with a longer-acting carbohydrate, like crackers and cheese, to stabilize blood sugar and prevent another drop. Avoid giving food or drink if the person is not fully conscious, as this could lead to choking.
Call emergency medical services immediately after glucagon administration, even if the person responds well. This ensures medical professionals can assess the situation and provide additional care. If there is no response within 15 minutes, a second dose of glucagon may be given if instructed by a healthcare provider. Inform healthcare providers about the incident for follow-up care and to determine why the severe hypoglycemia occurred.