Islets of Hope - Publication TRE-1-2006-fr

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	How to prepare & inject glucagon for treatment of severe low blood sugar in persons with diabetes Islets of Hope Publication TRE-1-2006-fr Revision date: 08/16//2008 Become familiar with the information in this publication BEFORE* an emergency!* If a person is able to eat or drink without choking, treat low blood sugar with fast acting carbohydrate. You do NOT have to be a medical professional to inject glucagon. Give glucagon if: the person is unconscious the person is unable to eat sugar or a sugar-sweetened product the person is having a seizure or convulsions, or repeated administration of sugar or a sugar-sweetened product such as a regular soft drink or fruit juice does not improve the patient's condition. There are five simple steps to injecting glucagon: Prepare glucagon Roll person onto their side Inject glucagon Feed the person as soon as they can take food by mouth Call 911 as necessary _________________________________ Important Medical Disclaimer. Material found in this publication is intended to provide you with general information and should in no way be used as a substitute for professional medical care or advice. If you have questions about the use of glucagon, consult a doctor, nurse, or pharmacist, and read the package insert to your glucagon kit BEFORE an emergency. About glucagon How glucagon helps raise blood glucose during hypoglycemia. Glucagon is a naturally occurring hormone produced by the pancreas. When the body releases glucagon, the hormone triggers the release of stored energy in the liver and muscles (glycogen). This released energy puts sugar into the blood stream and can raise the level of blood sugars. Storing glucagon. Store the kit at controlled room temperature between 20° to 25°C (68° to 77°F). Do not store in trunk of car, direct sunlight, or places where glucagon will be exposed to heat or cold. After mixing, use immediately. After dissolving glucagon with diluting solution it must be used immediately. Discard any unused portion. Solutions should be clear and of a water-like consistency at time of use. DO NOT USE glucagon kits after the expiration date stamped on the container. Call 911 if glucagon is expired or cannot be given for any reason whatsoever. Inject under the skin. Glucagon will only work when injected under the skin into muscle or into fatty tissue. You will not overdose the person by injecting glucagon. Side effects may occur, especially vomitting after injecting glucagon, and you should follow up with your doctor after injecting glucagon, but death from normal administration of glucagon has not been reported. WARNING A PERSON WITH DIABETES CAN LOSE CONSCIOUSNESS FROM EITHER LOW OR HIGH BLOOD SUGAR. IF YOU CAN TEST THE PERSON'S BLOOD SUGAR, DO SO EITHER BEFORE OR AFTER INJECTING GLUCAGON. THE PATIENT MAY BE IN A COMA FROM SEVERE HYPERGLYCEMIA (HIGH BLOOD GLUCOSE) RATHER THAN HYPOGLYCEMIA. IN SUCH A CASE, THE PATIENT WILL NOT RESPOND TO GLUCAGON AND REQUIRES IMMEDIATE MEDICAL ATTENTION IN A HOSPITAL! How to Prepare Glucagon for Injection The contents of the syringe are inactive. You must mix the contents of the syringe with the glucagon in the accompanying bottle before giving injection. Do not prepare glucagon for injection until you are ready to use it: Mix, use immediately, discard the rest. Turn patient on his/her side to prevent patient from choking and: Flip off Top Inject all liquid Swirl bottle gently from bottle; from syringe into until dry glucagon is wipe rubber bottle dissolved and clear stopper with like water alcohol swab Remove the flip-off seal from the bottle of glucagon. Wipe rubber stopper on bottle with alcohol swab. Remove the needle protector from the syringe. DO NOT REMOVE THE PLASTIC CLIP FROM THE SYRINGE. Inject the entire contents of the syringe into the bottle of glucagon. Remove syringe from the bottle. Swirl bottle gently until glucagon dissolves completely. GLUCAGON SHOULD NOT BE USED UNLESS THE SOLUTION IS CLEAR AND OF A WATER-LIKE CONSISTENCY. IF YOU CANNOT INJECT GLUCAGON FOR ANY REASON IMMEDIATELY CALL 911. How to Draw Glucagon into the Syringe Using the same syringe, hold bottle upside down and, making sure the needle tip remains in solution. Gently withdraw all of the solution (1 mg mark on syringe) from bottle. The plastic clip on the syringe will prevent the rubber stopper from being pulled out of the syringe; however, if the plastic plunger rod separates from the rubber stopper, simply reinsert the rod by turning it clockwise. The usual adult dose is 1 mg (1 unit). For children weighing less than 44 lb (20 kg), give 1/2 adult dose (0.5 mg). For children, withdraw 1/2 of the solution from the bottle (0.5 mg mark on syringe). Note: You can also use any syringe used to inject insulin to also inject glucagon. DISCARD UNUSED PORTION How to inject glucagon Inject glucagon the same way that you inject insulin. You can inject into the fat or muscle (fat is preferred, but don't worry - just get it under the skin). THERE IS NO DANGER OF OVERDOSE WHEN INJECTED UNDER THE SKIN. Using the following directions, inject glucagon IMMEDIATELY after mixing: If possible, cleanse injection site on buttock, arm, or thigh with alcohol swab. If you cannot do this, just go ahead with the injection anyhow. Inject just as you would insulin. Insert the needle into the loose tissue under the cleansed injection site, and inject all (or ½ the vial contents for children weighing less than 44 lbs.) of the glucagon solution. Do not remove needle immediately, count to 3 to make sure glucagon stays in. Apply light pressure at the injection site, and withdraw the needle. If possible, press an alcohol swab against the injection site for a few seconds to help stop bleeding and prevent leakage of the glucagon. If you see blood or clear fluid DO NOT WORRY. CRITICAL STEP --> Turn the patient on his/her side. When an unconscious person awakens, he/she may vomit. Turning the patient on his/her side will prevent him/her from choking. Call 911, but don't leave the person alone if at all possible. FEED THE PERSON AS SOON AS HE/SHE AWAKENS AND IS ABLE TO SWALLOW. Give them a fast-acting source of sugar (such as a regular soft drink or fruit juice) and a long-acting source of sugar (such as crackers and cheese or a meat sandwich). If the person does not awaken within 15 minutes, give another dose of glucagon if paramedics have not arrived yet. The patient's doctor should ALWAYS be notified whenever severe hypoglycemic reactions occur. What to do after injecting glucagon Keep person on their side; glucagon can cause vomiting Do not leave the person if at all possible Call 911 if necessary, then call parents (if the child is at school) Feed the person as soon as they are able to eat If person does not revive in 15 minutes give another shot of glucagon Watch for reactions to glucagon shots Follow-up with the patient's doctor Severe side effects are very rare but a few people may be allergic to one of the inactive ingredients in glucagon. Other side effects may include: rapid heartbeat nausea and vomiting feeling "hungover" Possible allergic reaction. If you see any reactions which are likely to have been caused by glucagon call 911 immediately. Possible allergic symptoms include hives, welts, rashes, convulsions, difficulty in breathing, swelling swelling of face, mouth, or tongue. If the person does not respond to glucagon WARNING A PERSON WITH DIABETES CAN LOSE CONSCIOUSNESS FROM EITHER LOW OR HIGH BLOOD SUGAR. IF YOU CAN TEST THE PERSON'S BLOOD SUGAR, DO SO EITHER BEFORE OR AFTER INJECTING GLUCAGON. THE PATIENT MAY BE IN A COMA FROM SEVERE HYPERGLYCEMIA (HIGH BLOOD GLUCOSE) RATHER THAN HYPOGLYCEMIA. IN SUCH A CASE, THE PATIENT WILL NOT RESPOND TO GLUCAGON AND REQUIRES IMMEDIATE MEDICAL ATTENTION IN A HOSPITAL! Islets of Hope Publication TRE-1-2006-fr; Revision date: 10/15/2006 This information may be used and distributed freely for non-commercial use. We do ask that you reference www.IsletsofHope.com.