1. Diabetes Care Tasks at School: What Key Personnel Need to Know Diabetes Care Tasks at School: What Key Personnel Need to Know GLUCAGON ADMINISTRATION

2. 2 Overall Goal: Optimal student health and learning Knowing about glucagon administration is critical to student success. But just one piece of comprehensive management plan. Exercise Legal Rights Glucagon Administration Health & Learning Nutrition Insulin Administration Hypoglycemia & Hyperglycemia Monitoring Blood Glucose Ketones

3. 3 Participants will learn: 4 What glucagon is 4 How glucagon should be stored 4 When glucagon is used 4 How to administer glucagon Learning Objectives

4. 4 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.

5. 5 Glucagon Kit Storage Place: As designated in DMMP accessible to school personnel. Store at room temperature Expiration date: Monitor After mixing, dispose of any unused portion within one hour.

6. 6 1 mg of freeze-dried glucagon (Vial) 1 ml of water for reconstitution (Syringe) Emergency Kit Contents: Combine immediately before use

7. 7 When to Give Glucagon If authorized by the student’s DMMP and if student exhibits: Unconsciousness, unresponsiveness Convulsions (seizures) Inability to safely eat or drink

8. 8 Procedure: Act Immediately Position student safely on side for comfort and protection from injury. Trained personnel notified to give glucagon in accordance with DMMP. Call 911, parents, school nurse as per DMMP

9. 9 Preparation 1. Flip cap off glass vial containing dry powder 2. Remove cap from syringe

10. 10 Mixing Solution 3. Inject entire fluid in syringe into the bottle containing powder 4. Shake gently or roll to mix until all powder is dissolved and solution is clear.

11. 11 Drawing Out 5. Inspect. Solution should be clear and colorless. 6. Draw prescribed amount of glucagon back into syringe.

12. 12 Dosing & Injecting 7. Clean site if possible. 8. Inject at 90° into the tissue under cleansed area buttocks thigh arm

13. 13 After Injecting 9.May take 10-20 minutes for student to regain consciousness. 10.Check blood sugar. 11.Give sips of fruit juice or regular soda, once student is awake and able to drink. 12. Advance diet as tolerated. 13. Document as per DMMP

14. 14 Don't Be Surprised If... Student does not remember being unconscious, incoherent or has a headache. Blood sugar becomes very high (over 200). Nausea or vomiting occurs.

15. 15 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.