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November 7, 2000

Other Medications, Social Issues: School and Daycare

Question from Potomac, Maryland, USA:

How important is it to inject glucagon into muscle as opposed to subcutaneously? Our middle school has advised that in an emergency they will not inject glucagon into muscle. They say they are prohibited from doing so. They have told us that if our doctor writes an order for glucagon to be injected into muscle, they are not allowed to administer the glucagon, and will not keep a dose at school. Will glucagon work, albeit maybe not as effectively or as fast, if it is injected subcutaneously?

Answer:

The middle school people with whom you are speaking to are making up rules. In an emergency medical situation, such as severe episodes of hypoglycemia, any nurse should know how to give injections in any fashion. After all, it is not very difficult to give injections. Glucagon works intravenously, subcutaneously and intramuscularly. So, in a practical sense, you do not have to worry about how it is given. In most young children and teenagers who are not obese, the injection would be very close to the muscle if aimed at the subcutaneous tissue anyway.

SB