States That Let EMTs Give You Glucagon During Severe Lows

It’s fair to assume that a 911 call about severe low blood sugar (hypoglycemia) will bring a pair of handsome doctors and emergency glucagon to your door in an ambulance. (We’ve watched too much Grey’s Anatomy, too.) 

Unfortunately, we’ve also learned that some state regulations may prevent emergency responders from administering glucagon to you, and that Jesse Williams is only acting—that’s real life. 

It’s kind of crazy that some states still don’t allow it despite modern options, but others are moving the needle—and that’s promising.

What is emergency glucagon?

Emergency glucagon is a medicine that can save lives in cases of severe hypoglycemia. It quickly raises blood sugar by signaling your liver to release stored sugar. 

Although today’s glucagon options are easy to use, laws still limit who can administer them. This is because the older glucagon emergency kit (GEK) had complicated steps that made it overwhelming for the average person to use. This kit set a standard that many states followed for years.

Today’s emergency glucagon options are different. They include:

• Nasal glucagon—Baqsimi®: This is an emergency glucagon that’s administered through your nose.
• Glucagon pen—Gvoke HypoPen®: This is a premixed glucagon injection that you press against your thigh. The auto-inject device makes it quick and easy to use. It is also available in a prefilled syringe (PFS).
• Glucagon Prefilled Syringe—Gvoke Kit®: This is a premixed glucagon in a vial that comes with a syringe, allowing you to draw up the dose manually and inject it directly into your thigh.
• Glucagon pen—Zegalogue®: Also a premixed glucagon, available as an easy-to-use auto-inject device. It is also available in a prefilled syringe (PFS).

These glucagon options are just as easy to give as Narcan, a nasal medicine used for overdose, or epinephrine, also known as an EpiPen, which is used to treat severe allergic reactions.

Still, not every medical professional is legally allowed to use them. But why? Let’s dig deeper.

Who can administer glucagon when you call 911?

Laws regarding who can administer emergency glucagon are still based on the (discontinued) GEK process, which involved many steps. This means that while emergency rescue staff should be able to administer simple one-step glucagon options, they may still not be legally authorized to do so because of laws that haven’t been updated.

When you call 911, any of the following medical professionals may arrive at your door. They are allowed to do the following when it comes to using glucagon on you during a low blood sugar episode:

• EMTs (emergency medical technicians): Varies by state
• AEMTs (advanced emergency medical technicians): Can generally administer glucagon across states
• Paramedics: Can generally administer glucagon across states

States that allow EMTs to treat lows with glucagon

Many states are updating which medical professionals can administer glucagon in emergencies. 

Some states have made laws or are trying to make laws that let EMTs use glucagon in emergencies when someone has very low blood sugar:

• Alaska: Alaska EMS rules state that EMTs can administer glucagon with additional department-approved training (15 hours).
• Connecticut: Senate Bill 1324, if passed, would authorize emergency medical services (EMS) to administer glucagon nasal powder.
• Illinois: The Illinois Department of Public Health (IDPH) EMS Systems have rules that vary by region. But many regions allow EMTs to administer glucagon.
• Kansas: The Kansas EMS Board allows EMTs to do more. Now, they can give glucagon.
• Minnesota: Minnesota EMS Regulatory Board (EMSRB) regulations allow basic EMT personnel to carry and administer glucagon.
• Montana: The Montana Department of Public Health and Human Services (EMS Protocols) allows basic EMT personnel to carry and administer glucagon.
• New Jersey: Senate Bill 3278, if passed, would extend permission to EMTs to perform blood glucose tests and administer glucagon via auto-injectors.
• Ohio: The State Board of Emergency Medical, Fire and Transportation Services said that EMTs and other certified Ohio EMS workers can now give glucagon through the nose or muscle to help people with hypoglycemia. This is now part of what they are trained to do.
• Virginia: The Virginia Office of EMS Medical Protocols includes glucagon among the actions EMTs can take for low blood sugar symptoms.
• Wisconsin: The Wisconsin Department of Health Services says EMT-Basics can administer glucagon when treating low blood sugar, following hypoglycemia guidelines.
• Washington, D.C.: Allows some EMTs to administer glucagon based on their level of training.

Advocate for the future and train your loved ones now

We hope that one day every emergency responder is authorized to administer glucagon and can use these simple, one-step forms to help people with very low blood sugar. Until then, keep emergency glucagon on hand, train your loved ones to use it, let them know where it is and keep refilling your prescription.

Every person with diabetes taking insulin or another blood-sugar-lowering medication should have glucagon.

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