Administration of Glucagon

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1. Identify that symptoms of a severe low blood sugar reaction are present and that based on the child’s diabetes emergency plan, medication needs to be given.
2. Call for assistance.  Ask that another school staff person call 911 or emergency medical services.
3. Explain the procedure to the child at his/her level of understanding.
4. Assemble supplies and place on a clean surface.
5. Review the student’s diabetes emergency action plan.
6. Check the glucagon kit and order to be sure it is
   1. For the right child
   2. The right medication
   3. The right dose
   4. Being given at the right time and
   5. Being given by the right route.
   6. Also check to ensure the medication has not expired.
7. Wash your hands if possible.
8. Put on gloves.
9. Remove the glucagon vial and syringe containing the liquid or diluent from the case.
10. Remove the gray cap from the vial.
11. Remove the cap from the syringe.
12. Place the needle tip in the center top of the vial and slowly push the diluent from the syringe into the vial.
13. Gently swirl the vial with the syringe still in the vial until the solution is clear (this takes about 10-15 seconds).
14. Turn the vial upside down, being sure that the needle does not fall out of the vial.
15. Pull the solution into the syringe, by pulling back on the plunger, as you withdraw the ordered amount of glucagon solution.
16. If present, remove air bubbles by tapping on the outside of the syringe and expelling the air or by pushing the dose back into the vial and pulling back on the plunger again.
17. Recheck the 5 rights again, checking the glucagon kit and order to be sure it is
    1. For the right child
    2. The right medication
    3. The right dose
    4. Being given at the right time and
    5. Being given by the right route.

18. Identify the location (buttock, thigh, or arm) for the injection.
19. Cleanse the injection site with an alcohol wipe.
20. Insert the needle into the skin at a 90 degree angle
21. Slowly inject the solution.
22. Remove syringe.
23. Put the used syringe in the carrying case.
24. Close the carrying case to avoid a possible needle stick injury.
25. Apply pressure using the alcohol wipe and gently massage injection site.
26. If the student is not lying on their side, move the student to a side-lying position because vomiting often follows the injection of glucagon.
    • If needed, ask another person for assistance.
27. If alone with student, and you have not already called 911 or emergency medical service, do so now.
28.  Monitor the student’s arousal, pulse and respirations.
29. If breathing stops, begin rescue breaths.
30. If breathing and heartbeat stop, begin CPR.
31. Maintain a side-lying position to prevent aspiration due to vomiting.
32. Once rescue squad arrives, inform them of medication administered, including type of medication, dose and time.
    • Send along glucagon kit along with used dose.
33. Dispose of all used materials in proper receptacles.
34. Remove gloves and wash hands.
35. Follow up with the parent or guardian and healthcare provider, as needed
36. Document the event and administration of glucagon, including time, date, dosage, and site of administration.

Page last updated: July 24, 2015