wizzard wrote:ZO100_marto wrote:Say for example you live in Cannington and are a diabetic, you could have a van that shows up and gives you some glucose gel in your gums and oxygen on the way to hospital or you could van that shows up, administers glucagon maybe some gel and can often leave you in the comfort of your own home after watching you eat some carbs, drink some juice etc saving you the hassle of being "baby sitted" at an ED for several hours.
AS per 2007 St John Clinical Practice Guildlines:
Glucagon:
Prepare Patient For Transport
- Patient must be prepared and transported without delay
- Do not wait for Medication to take effect
Glucose oral gel:
Prepare Patient For Transport
- Patient must be prepared and transported without delay
- Do not wait for Medication to take effect
From what i read there isn't must difference apart from Route of Administration
slight difference:
glucoise oral gel is purely glucose. ?it may have some artificial carb content, but if so not much
glucagon is a hormone that releases stores of "sugars" from the liver (in laymans terms)
they work different ways. as the take out for time for the Intramuscular Route (Gluagon) is rougly 1-5 mins, Patient depending, u will get a result quicker, feed the Pat some carbs and go on your way. Correct statement is that it is an "in transit med" so if there is no response to the med or some other underlying cause for the altered conscious state, say for instance something like unresolved hypoxia in an unnoticed HI, then transport would be undertaken by AP's ASAP. Otherwise, its stay and play for this one.
Glucose Gel on the other hand is a pain in the ass (ok for an ambo who needs a 3am sugar fix!!! least it was till we went lemon flavored). problem is the intra oral route (or buccal mucosa for those med bods that will correct me, cause we all know the gel is absorbed by the buccal mucosa and not ingested) is at its best unreliable. most diabetics, apart from those who are unconscious, present agitated, or drunk like if u must, and when we squeeze 32g of gel into their mouths, they love to spit it, so how much do they get and how can it possibly be effective. Likewise I'm kinda not willing to airway compromise my unconscious pt with 32g of gel
so in the management of hypoglycemia with altered conscious state, a quick tackle, hold, inject and standf back works for me.
Vollies do a great job, and they now have access to some good meds: ie aspirin and vaso dilators for cardiac chest pain (same as para's), adrenaline for acute allergy (same as paras, although in an epipen), and salbutamol for asthma and also allergies (paras also use adrenaline for asthma that vollies cant).
They do a great job and u can spot the good vollies, they are the ones who recognise their limitiations and call for ALS backup if avail and in the metro area, or country towns where paramedics are.
