A new paper co-authored by Joslin’s CMO Robert A. Gabbay, MD, PhD finds administration of life-saving medicine not in scope of practice for EMTs

Boston, MA—(January 16, 2018) — For people with diabetes, a hypoglycemic episode where blood sugar drops dangerously can mean the loss of brain tissue or even death. But if you call 911 due to a hypoglycemic episode there is roughly a 3 in 4 chance the emergency medical responder will be unable to give you glucagon, a life-saving medication that stops the attack, according to a recent finding published in the Annals of Internal Medicine. The study was co-authored by Robert Gabbay, MD, PhD, and Chief Medical Officer at Joslin, Nicole E. Wagner, B.A. of Joslin, and Peter A. Kahn, MD, MPH, ThM, of Yale School of Medicine.

While paramedics have specialized medical training that allows them to administer more types of emergency treatments such as glucagon, emergency medical technicians, or EMTs, do not. Paramedics are the only emergency responders currently allowed to carry and administer glucagon in most of the United States. There are nearly 200,000 EMTs versus only about 60,000 paramedics, meaning there might be a 75 percent chance a responder will be unable to give a potentially life-saving treatment. 

“These restrictions are even more surprising given that glucagon is routinely administered by family members, and the side effects experienced by those receiving glucagon were not serious and most typically include nausea,” the paper states. 

The study also uncovered that of all the diabetes-related calls they received, 911 dispatchers only told EMTs they would be responding to a diabetic emergency in 44 percent of cases. “[This] potentially increas[es] the likelihood of dispatching providers who cannot administer glucagon to patients suffering from hypoglycemia,” the paper says.

“All emergency personnel should have access to glucagon along with training to safely administer glucagon to minimize unintended treatment accidents,” Dr. Gabbay and his fellow authors state. “Ensuring this access represents an important opportunity to reduce morbidity, mortality and healthcare costs. Diabetes specialists should work with emergency medical personnel to design curricula for the safe and effective use of glucagon nationwide.”

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