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Anaphylaxis & Glucagen
Hi I'm new to the site. I'm a UK Paramedic and have a question regarding the way in which glucagen works.
The reason I'm asking is due to an incident that recently occurred. I shall explain, please bear with me.
Called to a patient in cardiac arrest secondary to anaphylaxis, had to perform a surgical airway due to his airway being too swollen to intubate, he had intravenous access and intraosseous access, IV fluids, 5x 1mg Iv adrenaline 1:10,000 and 3mg atropine. When we arrived at hospital he was worked on for over an hour, including sodium bicarb, chlorphenamine (which we carry aswell but didn't give it as would probably be next to useless in this situation). Now the patient was on beta blockers which may explain why adrenaline was having no effect. The part that I'm really interested in is that one of the DRs said let's try glucagen. There wasn't any close to hand so one of my colleagues got three 1mg vials from the ambulance by which time the DRs in resus had called it and pronounced the patient dead.
So my question is this: would glucagen be effective in anaphylaxis in patients unresponsive to adrenaline, whether they be alert, semi conscious or in cardiac arrest. In a patient who is still alive we give adrenaline 1:1000 I.M. We carry Glucagen but only use it for hypoglycaemia (although I prefer I.V/I.O glucose and only use glucagen if I can't get access), I know glucagen is effective in Betablocker O.D and would call the hospital to get the go ahead in that case. But in anaphylaxis? Any answers would be great. Sorry it was a bit long winded.
Hi I'm new to the site. I'm a UK Paramedic and have a question regarding the way in which glucagen works.
The reason I'm asking is due to an incident that recently occurred. I shall explain, please bear with me.
Called to a patient in cardiac arrest secondary to anaphylaxis, had to perform a surgical airway due to his airway being too swollen to intubate, he had intravenous access and intraosseous access, IV fluids, 5x 1mg Iv adrenaline 1:10,000 and 3mg atropine. When we arrived at hospital he was worked on for over an hour, including sodium bicarb, chlorphenamine (which we carry aswell but didn't give it as would probably be next to useless in this situation). Now the patient was on beta blockers which may explain why adrenaline was having no effect. The part that I'm really interested in is that one of the DRs said let's try glucagen. There wasn't any close to hand so one of my colleagues got three 1mg vials from the ambulance by which time the DRs in resus had called it and pronounced the patient dead.
So my question is this: would glucagen be effective in anaphylaxis in patients unresponsive to adrenaline, whether they be alert, semi conscious or in cardiac arrest. In a patient who is still alive we give adrenaline 1:1000 I.M. We carry Glucagen but only use it for hypoglycaemia (although I prefer I.V/I.O glucose and only use glucagen if I can't get access), I know glucagen is effective in Betablocker O.D and would call the hospital to get the go ahead in that case. But in anaphylaxis? Any answers would be great. Sorry it was a bit long winded.
and God damn we are that good
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