Glucagon Training

7/28/2019 Glucagon Training

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With Glucagon Training for School Staff


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Understand what diabetes is.

Recognize a hypoglycemic reaction.

Understand the intended purpose andthe side effects of a glucagon injection.

Be able to draw up and inject glucagon

as needed.

Goals for today


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Exercise

LegalRights

GlucagonAdministration

Health

&

Learning

Nutrition

InsulinAdministration

Hypoglycemia&

Hyperglycemia

Ketones

Monitoring

BloodGlucose

Overall Goal:

Optimal Student Health and Learning

Knowing about

glucagonadministration is critical

to student success. But

just

one piece of acomprehensive

management plan.


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Diabetes is a condition in which the body

cannot use or does not produce enough

insulin. Without insulin, the body cannot get the

blood glucose (that is the result of food

digestion) into the cells for energy.

What is Diabetes


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Without Insulin

Eat Blood Glucose Goes Higher

No Blood Glucose In Eat

Cells

Eat Blood Glucose Goes Higher

The blood glucose cannot get into the cells to

provide energy without insulin.

Without insulin high levels of blood glucose build

up in the blood causing hyperglycemia aka high

blood sugar.


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Hyperglycemia
http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=cGZV2ACBE4w3sM&tbnid=M8kuB_FhuL1VEM:&ved=0CAUQjRw&url=http://www.lifeclinic.com/focus/diabetes/kids_symptoms.asp&ei=PEuuUeG1BqrqiwKX5YCYAQ&bvm=bv.47380653,d.cGE&psig=AFQjCNFeqoZqAf2T52zuBr_mrV14N8EdbA&ust=1370463394292878


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Frequent urination

Increased hunger

Fatigue/weakness

Weight loss

Blurry vision

Fast, deep breathing

Increased thirst Slow or confused

thinking

HYPERGLYCEMIA

Signs and symptoms


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Blood glucose checking

Daily blood glucose

checking is an important

part of diabetes control.

Blood glucose checks are

usually done before meals,

at bedtime, and with

exercise.

When in doubt, CHECK the

blood glucose if the studentis not feeling well or is

complaining of feeling low.
http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=uT940MCjULRQ-M&tbnid=NWRuGouOXXmMiM:&ved=0CAUQjRw&url=http://dlife.com/diabetes/blood_sugar_management&ei=nRitUefOH8OLiwKu9oHACg&psig=AFQjCNFqoFkmRn4KfigWJHzLiBCwJMjCaA&ust=1370384915174880


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Insulin

Insulin is a hormone

secreted by the

pancreas. With

diabetes it must begiven as an injection.

The dose will vary with

the blood glucose

level, food intake andexercise.
http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=tazw1oOveiu9_M&tbnid=rmfhzuiqEZ23nM:&ved=0CAUQjRw&url=http://www.diabetesmine.com/2012/06/ada-news-insulin-is-safe-but-type-1s-still-faring-poorly.html&ei=1U6uUZufK8jPiwLKgoHADw&psig=AFQjCNELj_MV5__zY-fRRSZS8AmUVVtheA&ust=1370464240805271


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Lower the blood

glucose.

Facilitate theblood glucose

getting into the

cells to provide

energy.

Insulin should


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Exercise

When the student exercises, the

body uses the blood glucose

more effectively, which can

lead to low blood glucose

(hypoglycemia).

Stress and illness may also effect

blood glucose level.
http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=ah9_eQeYSsNZPM&tbnid=G1VuR8mPrKERPM:&ved=0CAUQjRw&url=http://www.peacefulplaygrounds.com/playground-liability-accident-or-injury/&ei=8E-uUbnGLOOziQLOyIHoBw&psig=AFQjCNGgH-1cUYvU_xm6ILK7FuyZTGykPA&ust=1370464596794250http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=ah9_eQeYSsNZPM&tbnid=G1VuR8mPrKERPM:&ved=0CAUQjRw&url=http://www.peacefulplaygrounds.com/playground-liability-accident-or-injury/&ei=8E-uUbnGLOOziQLOyIHoBw&psig=AFQjCNGgH-1cUYvU_xm6ILK7FuyZTGykPA&ust=1370464596794250


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Insulin can cause blood

glucose to fall too low when:

Too much insulin is given.

Too much exercise.

Not enough food is eaten.
http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=yQw5bWNgcgvgCM&tbnid=5i0FxymqAEnLCM:&ved=0CAUQjRw&url=http://sdpathaniashealthyliving.blogspot.com/2013/03/hypoglycemia-in-diabetics.html&ei=C1GuUdrHO-SRiQLU_4DYCw&psig=AFQjCNHVtEH9YDgZXP_n87NDpyaJJnbRXQ&ust=1370464861722006http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=yQw5bWNgcgvgCM&tbnid=5i0FxymqAEnLCM:&ved=0CAUQjRw&url=http://sdpathaniashealthyliving.blogspot.com/2013/03/hypoglycemia-in-diabetics.html&ei=C1GuUdrHO-SRiQLU_4DYCw&psig=AFQjCNHVtEH9YDgZXP_n87NDpyaJJnbRXQ&ust=1370464861722006


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Hypoglycemia can be life threatening if not

treated because the only energy source for thebrain is blood glucose.

This is called

hypoglycemia


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Symptoms of

hypoglycemia

Symptoms can

progress to:

Confusion

Blurred Vision

Late stages of

hypoglycemia may

include: Coma

Seizure

Death

Pale

Shaky

Hunger

HeadacheTingling

Mood Change

Sleepiness

Sweating

Dark eyes


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Hypoglycemia Treatment for a

conscious person:If you can, check the blood glucose. If it is

below 70 mg/dL, treat as a hypoglycemicreaction.

When in doubt or unable to check the blood

glucose, treat as a hypoglycemic reaction.

Give a drink high in sugar

6oz. of regular soda pop (not diet),

4-6 ounces of fruit juice

3-4 glucose tablets

Follow with a milk and protein or sendthem to lunch if they can eat within 10 to

15 minutes
http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=yvoKhN3xm22H4M&tbnid=OFlbfWPacWFwnM:&ved=0CAUQjRw&url=http://urbanext.illinois.edu/diabetesinteens/hypoglycemia.cfm&ei=7lauUfz1MaXLyQH49IGYAw&psig=AFQjCNFI4TgxL2SNRreXQWd-HwfwGk5JOQ&ust=1370466402228472


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Stay with the child!

You should see a response within

15 20 minutes.

You can repeat thetreatment in 15 minutes if

symptoms are still present

or if they become worse.
http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=oKta_yMFK8zznM&tbnid=IC1BCSobhmvMVM:&ved=0CAUQjRw&url=http://balancedlifeskills.com/home/2010/12/23/8-steps-to-prevent-bullying-in-the-classroom-for-teachers.html&ei=BVmuUbv-BeWsyAGkwYG4CA&psig=AFQjCNFmFhjuvDSSSeh8IiFbVUR8Zo1mnA&ust=1370466927922387


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Hypoglycemia Treatment with

decreased awarenessIf the student is still able to chew and swallow without difficulty you

may give glucose gels and/or tablets to treat hypoglycemia. Gels

are placed in the students mouth toward the cheek and back teeth.

Examples: Glucose tablets, Dextrose tablets, Gel frosting or honey.

Do not attempt to give a child with significantly decreased cognitive

awareness anything to eat or drink as they are at risk for choking.


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Glucagon

Lilly Glucagon

Emergency Kit

Novo Nordisk

GlucoGen HypoKit


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What Is Glucagon? Naturally occurring hormone made in the pancreas.

A life-saving, injectable hormone that raises blood glucose level by

stimulating the liver to release stored glucose. Treatment for severe hypoglycemia.

Can save a life.

Cannot harm a student cannot overdose.

Pancreas

Liver
http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=Yfa-772Ps5HQBM&tbnid=OFI9LUig3m2SsM:&ved=0CAUQjRw&url=http://kumpulan-dongeng.blogspot.com/2012/01/body-parts-trachea-esophagus-heart.html&ei=UV6uUYG5IYTFyAH-gIGABA&psig=AFQjCNEuE03r8oAAYDFkUEyLaeKv56X_Vg&ust=1370468287688334http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=Yfa-772Ps5HQBM&tbnid=OFI9LUig3m2SsM:&ved=0CAUQjRw&url=http://kumpulan-dongeng.blogspot.com/2012/01/body-parts-trachea-esophagus-heart.html&ei=UV6uUYG5IYTFyAH-gIGABA&psig=AFQjCNEuE03r8oAAYDFkUEyLaeKv56X_Vg&ust=1370468287688334http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=Yfa-772Ps5HQBM&tbnid=OFI9LUig3m2SsM:&ved=0CAUQjRw&url=http://kumpulan-dongeng.blogspot.com/2012/01/body-parts-trachea-esophagus-heart.html&ei=UV6uUYG5IYTFyAH-gIGABA&psig=AFQjCNEuE03r8oAAYDFkUEyLaeKv56X_Vg&ust=1370468287688334


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We recommend glucagon

be storedin an unlocked cabinet at

the front office however, some students

may prefer to carry their glucagon.

Store at room temperature

Expiration date: Monitor

After mixing use immediately

Please refer to the students

Individualized Health Care Plan andphysicians orders.


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Emergency Kit Contents:

1 mg of freeze-dried glucagon (Vial)

1 ml of water for reconstitution (Syringe)

Combine immediately before use


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When to Give Glucagon

If authorized by the students Health

Care Plan/504 and if student exhibits:

Unconsciousness, unresponsiveness

Convulsions (seizures)

Inability to safely eat or drink


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Treatment for an unconscious student:

Identify someone to call 911

Identify someone to get Glucagon

Turn student on their side

Administer Glucagon

Call the parent

Stay with the student and watch for signs and symptoms

of adverse reactions

Do not recap needle, place syringe in kit box

Send Glucagon with EMS
http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=LIjiWUb9oQcoKM&tbnid=fEIb4HcYhkGX-M:&ved=0CAUQjRw&url=http://publikworks.wordpress.com/tag/ambulance/&ei=pl2uUeWAB5LMywGA4oHwDw&psig=AFQjCNFBCE1fUCDaIYpqZnYAsyhe_P3RbA&ust=1370468117590139http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=LIjiWUb9oQcoKM&tbnid=fEIb4HcYhkGX-M:&ved=0CAUQjRw&url=http://publikworks.wordpress.com/tag/ambulance/&ei=pl2uUeWAB5LMywGA4oHwDw&psig=AFQjCNFBCE1fUCDaIYpqZnYAsyhe_P3RbA&ust=1370468117590139


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Glucagon Adverse Reactions

The most common side effects are

nausea and vomiting.

These reactions may also occur with

hypoglycemia.

Keep the student positioned on his or her side.
http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=DsimgtQXFWloNM&tbnid=HzxOwq05570aeM:&ved=0CAUQjRw&url=http://umaeenews.blogspot.com/2012/04/treatment-nausea-and-vomiting.html&ei=i2KuUcWcAoi9ywGOooDQBQ&psig=AFQjCNF4g9GQWGrEObDW3U3Qj4i4mKS1xw&ust=1370469376080948


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After Injecting Glucagon

May take 10-20 minutes for student to regain consciousness.

Check blood sugar.

Give sips of fruit juice or regular soda, once student is awake

and able to drink.

Advance diet as tolerated.

Document as per Health Care Plan or 504


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Student does not remember being

unconscious, incoherent or has aheadache.

Blood sugar becomes very high (over

200).

Nausea or vomiting occurs.

Don't Be Surprised If. . .
http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=RaxAHHCrKDhcIM&tbnid=v_jVQrj70PoDuM:&ved=0CAUQjRw&url=http://3daccounting.com.au/&ei=g2SuUYvJI-bkyQHM04GQAw&psig=AFQjCNE9NLuKCBwup4DsBfVFu2P2nBSvZg&ust=1370469864072994http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=RaxAHHCrKDhcIM&tbnid=v_jVQrj70PoDuM:&ved=0CAUQjRw&url=http://3daccounting.com.au/&ei=g2SuUYvJI-bkyQHM04GQAw&psig=AFQjCNE9NLuKCBwup4DsBfVFu2P2nBSvZg&ust=1370469864072994


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Why has this become

necessary The goal of diabetes care is to keep the

blood glucose closer to normal. Despite

best efforts hypoglycemiawill occur.

Glucagon is the fastest means

to raise the blood glucose level.


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Considerations

The time to complete recovery from a severe hypoglycemic

episode varies according to how low the blood glucose level

was and for how long prior to treatment.

A seizure may occur even if the blood sugar is within the target

range if it drops precipitously and a lot.

Some signs and symptoms, such as headache, may persist for

several hours, although the blood sugar level is satisfactory.Continued monitoring is important.


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THE LAW

53A-11-603

CARE OF STUDENTS WITH DIABETES IN SCHOOL

A public school shall, within a reasonable time after receiving a glucagon

authorization, train two or more school personnel who volunteer to be

trained in the administration of glucagon, with training provided by the

school nurse or another qualified licensed medical professional.

School personnel who provide or receive training under this section and act

in good faith are not liable in any civil or criminal action for any act taken or

not taken under the authority of this section with respect to the

administration of glucagon.
http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=5Rx_-cRPKex2RM&tbnid=lvyO1LTLBn2rnM:&ved=0CAUQjRw&url=http://www.commoncause.org/site/pp.asp?c=5nJCJQPvEhKUE&b=7501935&ei=QWWuUeagAsWGyAGt3IGADw&psig=AFQjCNEck4J__aSQfrDh_KJVXfWpKwkpfQ&ust=1370470079402587http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=5Rx_-cRPKex2RM&tbnid=lvyO1LTLBn2rnM:&ved=0CAUQjRw&url=http://www.commoncause.org/site/pp.asp?c=5nJCJQPvEhKUE&b=7501935&ei=QWWuUeagAsWGyAGt3IGADw&psig=AFQjCNEck4J__aSQfrDh_KJVXfWpKwkpfQ&ust=1370470079402587http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=5Rx_-cRPKex2RM&tbnid=lvyO1LTLBn2rnM:&ved=0CAUQjRw&url=http://www.commoncause.org/site/pp.asp?c=5nJCJQPvEhKUE&b=7501935&ei=QWWuUeagAsWGyAGt3IGADw&psig=AFQjCNEck4J__aSQfrDh_KJVXfWpKwkpfQ&ust=1370470079402587http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=5Rx_-cRPKex2RM&tbnid=lvyO1LTLBn2rnM:&ved=0CAUQjRw&url=http://www.commoncause.org/site/pp.asp?c=5nJCJQPvEhKUE&b=7501935&ei=QWWuUeagAsWGyAGt3IGADw&psig=AFQjCNEck4J__aSQfrDh_KJVXfWpKwkpfQ&ust=1370470079402587http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=5Rx_-cRPKex2RM&tbnid=lvyO1LTLBn2rnM:&ved=0CAUQjRw&url=http://www.commoncause.org/site/pp.asp?c=5nJCJQPvEhKUE&b=7501935&ei=QWWuUeagAsWGyAGt3IGADw&psig=AFQjCNEck4J__aSQfrDh_KJVXfWpKwkpfQ&ust=1370470079402587http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=5Rx_-cRPKex2RM&tbnid=lvyO1LTLBn2rnM:&ved=0CAUQjRw&url=http://www.commoncause.org/site/pp.asp?c=5nJCJQPvEhKUE&b=7501935&ei=QWWuUeagAsWGyAGt3IGADw&psig=AFQjCNEck4J__aSQfrDh_KJVXfWpKwkpfQ&ust=1370470079402587http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=5Rx_-cRPKex2RM&tbnid=lvyO1LTLBn2rnM:&ved=0CAUQjRw&url=http://www.commoncause.org/site/pp.asp?c=5nJCJQPvEhKUE&b=7501935&ei=QWWuUeagAsWGyAGt3IGADw&psig=AFQjCNEck4J__aSQfrDh_KJVXfWpKwkpfQ&ust=1370470079402587http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=5Rx_-cRPKex2RM&tbnid=lvyO1LTLBn2rnM:&ved=0CAUQjRw&url=http://www.commoncause.org/site/pp.asp?c=5nJCJQPvEhKUE&b=7501935&ei=QWWuUeagAsWGyAGt3IGADw&psig=AFQjCNEck4J__aSQfrDh_KJVXfWpKwkpfQ&ust=1370470079402587http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=5Rx_-cRPKex2RM&tbnid=lvyO1LTLBn2rnM:&ved=0CAUQjRw&url=http://www.commoncause.org/site/pp.asp?c=5nJCJQPvEhKUE&b=7501935&ei=QWWuUeagAsWGyAGt3IGADw&psig=AFQjCNEck4J__aSQfrDh_KJVXfWpKwkpfQ&ust=1370470079402587http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=5Rx_-cRPKex2RM&tbnid=lvyO1LTLBn2rnM:&ved=0CAUQjRw&url=http://www.commoncause.org/site/pp.asp?c=5nJCJQPvEhKUE&b=7501935&ei=QWWuUeagAsWGyAGt3IGADw&psig=AFQjCNEck4J__aSQfrDh_KJVXfWpKwkpfQ&ust=1370470079402587http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=5Rx_-cRPKex2RM&tbnid=lvyO1LTLBn2rnM:&ved=0CAUQjRw&url=http://www.commoncause.org/site/pp.asp?c=5nJCJQPvEhKUE&b=7501935&ei=QWWuUeagAsWGyAGt3IGADw&psig=AFQjCNEck4J__aSQfrDh_KJVXfWpKwkpfQ&ust=1370470079402587


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Information Adapted from the

American Diabetes Association

Documents

Glucagon Training