A Monzani1, S Savastio1, A Manzo1, A Scalogna2, E Pozzi1, P P Sainaghi3, F Della Corte2,3, I Rabbone4. 1. Division of Paediatrics, Department of Health Sciences, University of Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy. 2. SIMNOVA Interdepartmental Centre for Innovative Learning and Simulation in Medicine and Allied Health Professions, University of Piemonte Orientale, via Lanino 1, 28100, Novara, Italy. 3. Department of Translational Medicine, University of Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy. 4. Division of Paediatrics, Department of Health Sciences, University of Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy. ivana.rabbone@uniupo.it.
Abstract
AIMS: To evaluate: (i) the propensity of paediatrics and emergency medicine residents to select different therapeutic options and (ii) the speed and administration success in a high-fidelity simulation of severe hypoglycaemia in a child with type 1 diabetes (T1DM). METHODS: In this single-centre high-fidelity simulation study, 51 paediatrics or emergency medicine residents were exposed to a scenario of severe hypoglycaemia in a T1DM child attending an ambulatory setting, before and after a training on the preparation and administration of both injectable and IN glucagon. Time for drug delivery and its effectiveness were collected. RESULTS: Before training, 45.1% of participants chose to administer injectable glucagon, 43.1% intravenous glucose solution, 5.9% intranasal (IN) glucagon, and 5.9% took no action. Administration was successful in 74% of injectable glucagon, 33.3% intravenous glucose solution, and 22.7% IN glucagon. After training, 58.8% of participants chose IN and 41.2% injectable glucagon, with 100% of successful administrations for IN glucagon and 90.5% for injectable glucagon. Time to successful administration was shorter for IN than injectable glucagon (23 ± 10 vs. 38 ± 7 s, p < 0.0001). CONCLUSIONS: IN glucagon is an easy and effective option for severe hypoglycaemia treatment, with an almost zero possibility of failure provided that adequate training is imparted.
AIMS: To evaluate: (i) the propensity of paediatrics and emergency medicine residents to select different therapeutic options and (ii) the speed and administration success in a high-fidelity simulation of severe hypoglycaemia in a child with type 1 diabetes (T1DM). METHODS: In this single-centre high-fidelity simulation study, 51 paediatrics or emergency medicine residents were exposed to a scenario of severe hypoglycaemia in a T1DM child attending an ambulatory setting, before and after a training on the preparation and administration of both injectable and IN glucagon. Time for drug delivery and its effectiveness were collected. RESULTS: Before training, 45.1% of participants chose to administer injectable glucagon, 43.1% intravenous glucose solution, 5.9% intranasal (IN) glucagon, and 5.9% took no action. Administration was successful in 74% of injectable glucagon, 33.3% intravenous glucose solution, and 22.7% IN glucagon. After training, 58.8% of participants chose IN and 41.2% injectable glucagon, with 100% of successful administrations for IN glucagon and 90.5% for injectable glucagon. Time to successful administration was shorter for IN than injectable glucagon (23 ± 10 vs. 38 ± 7 s, p < 0.0001). CONCLUSIONS: IN glucagon is an easy and effective option for severe hypoglycaemia treatment, with an almost zero possibility of failure provided that adequate training is imparted.
Authors: Mary B Abraham; Timothy W Jones; Diana Naranjo; Beate Karges; Abiola Oduwole; Martin Tauschmann; David M Maahs Journal: Pediatr Diabetes Date: 2018-10 Impact factor: 4.866
Authors: Ivana Rabbone; Anna Missineo; Sara Zanetta; Giuseppina Salzano; Riccardo Schiaffini; Andrea E Scaramuzza; Fortunato Lombardo Journal: Diabetes Obes Metab Date: 2021-04-23 Impact factor: 6.577
Authors: Dana C Perantie; Jenny Wu; Jonathan M Koller; Audrey Lim; Stacie L Warren; Kevin J Black; Michelle Sadler; Neil H White; Tamara Hershey Journal: Diabetes Care Date: 2007-06-15 Impact factor: 19.112
Authors: Devada Singh-Franco; Cynthia Moreau; Andrea D Levin; Daisy De La Rosa; Melinda Johnson Journal: Clin Ther Date: 2020-08-29 Impact factor: 3.393