Can EMTs + Paramedics Administer Emergency Glucagon for Severe Hypoglycemia?
It’s easy to assume that a phone call to 911 for severe hypoglycemia means an emergency crew will arrive to administer emergency glucagon—but it’s not that simple.
Despite how easy-to-use today’s modern glucagon options are, the rules on who can legally administer glucagon are still quite limiting due to the more complicated steps of the outdated glucagon emergency kit (GEK).
Let’s take a closer look at why today’s glucagon options are different, who can administer them, and what you can do to help modernize your local emergency services.
What is emergency glucagon?
Emergency glucagon is a life-saving medication that raises blood sugar levels by telling your liver to quickly release stored sugar. While the old GEK required several confusing steps, modern glucagon medications are easy-to-administer with a 1-step process.
Today’s modern glucagon medications include:
- Baqsimi nasal glucagon
- Gvoke HypoPen or Prefilled Syringe (PFS)
- Zegalogue auto-injector
- Video: How these new glucagon medications work.
These glucagon options are as easy to administer as Narcan—a nasal medication to treat drug overdose—or epinephrine (commonly known as an “Epi-pen”) used to treat anaphylactic shock due to severe allergic reactions.
Who can administer glucagon when you call 911?
Laws regarding who can administer emergency glucagon are still based on the complicated GEK involving multiple steps. This means that while any emergency rescue staff ought to be able to administer easy 1-step glucagon options, they still might not be legally able to.
When you call 911, any of the following might show up at your door:
- EMT (emergency medical technician): Cannot administer glucagon
- AEMT (advanced EMT training level): Can administer glucagon
- Paramedic: Can administer glucagon
*Learn more about these emergency service roles.
Edward Waite, Fire Captain in Hinesburg, Vermont, is also an EMT. He’s lived with type 2 diabetes for about 8 years—and said that the ability to administer glucagon would be a game-changer for emergency rescue services.
“It works very well,” said Waite. “The older glucagon kit is intramuscular, which means it’s easy to administer in someone’s living room during severe hypoglycemia because it doesn’t require an intravenous (IV) line as you’d need for D10 or D50, which is intravenous glucose.”
As an EMT, Waite is not permitted to administer any type of emergency glucagon.
“Getting that advanced EMT certification is another 100-hour training, basically a semester of training, followed by a national registry exam within a certain amount of time since the class. If you wait too long to take the exam, you’ll have to retake the 100-hour training again.”
Waite has attempted to earn his advanced EMT certification but he didn’t pass the exam the first time and endured a spinal injury that derailed his second try taking the class.
Many rescue services are now requiring an AEMT before they’ll consider hiring you, explained Waite.
In the small town of Hinesburg, Waite said they will tell the 911 dispatcher to look specifically for an EMT-A or paramedic who can administer glucagon if the emergency is diabetes-related.
“Sometimes we can get an AEMT or paramedic on the call, sometimes we can’t,” said Waite, which means the person in need will require an ambulance to be transported to the hospital. For a small town, this isn’t easy either.
“We don’t have an ambulance, we’re showing up in regular vehicles and working in people’s living rooms,” said Waite. “If we could administer emergency glucagon that easily, that would be amazing.”
The bottom line
Your local emergency services may not even know these modern types of glucagon exist! Reach out to your local services and share this article with them. Eventually, we hope to see every emergency service provider legally allowed to administer these easy single-step forms of emergency glucagon to patients experiencing severe hypoglycemia.
Editor’s Note: Educational content related to emergency glucagon is made possible with support from Lilly an active partner of Beyond Type 1 at the time of publication. Editorial control rests solely on Beyond Type 1.