Part 2: Emergency Response & Glucagon

What you'll learn

Know the exact steps for helping an unconscious or seizing person
Administer glucagon confidently (nasal, injectable, or auto-injector)
Handle resistance and combativeness during a low
Know what to expect after glucagon administration

If They Cannot Swallow or Are Unconscious

This is an emergency. Follow these steps in order:

Do NOT put food or liquid in their mouth — choking risk
Call emergency services (15/SAMU or 112 in Europe, 911 in the US)
Administer glucagon if available and you know how
Turn them on their side (recovery position)
Stay with them until help arrives
Time how long they're unconscious

Warning

NEVER put food or liquid in an unconscious person's mouth — they could choke. If someone cannot safely swallow, use glucagon and call emergency services immediately.

Glucagon Quick Reference by Type

Baqsimi (Nasal) — Easiest

Pull off the red cap
Insert tip in one nostril
Press plunger until green line disappears
They don't need to inhale — it absorbs through the membrane

Gvoke (Auto-injector) — Very Easy

Pull off red cap
Press against outer thigh (through clothing is fine)
Press button and hold 5 seconds
Remove

Traditional Kit — Most Complex

Mix powder and liquid in the vial
Draw solution into syringe
Inject into thigh, upper arm, or buttocks

After ANY type: Turn person on their side and call emergency services.

Dealing with Resistance

People having a low may:

Insist they're fine ("Leave me alone!")
Refuse treatment
Become angry or combative
Push you away
Not recognize they need help

How to handle it:

Don't	Do
Argue or confront	Stay calm and patient
Force food into their mouth	Speak simply and clearly
Take it personally	Try: "Please drink this for me"
Give up and walk away	If they're unsafe, call emergency services

Scenario: Ana Helps Her Resistant Teenager

Ana's 15-year-old son Miguel has T1D. At dinner, she notices he's pushing food around his plate and snapping at his sister. His CGM shows 52 mg/dL.

"Miguel, you're low. Have some juice." Miguel glares: "I'm FINE, Mom. Stop treating me like a baby."

Ana doesn't argue. She places a glass of orange juice next to his plate and says quietly: "I know it's annoying. Just a few sips, please." She sits down calmly. After a tense moment, Miguel takes the juice.

Twenty minutes later, Miguel says: "Sorry about that, Mom. I didn't realize how low I was." Ana smiles: "That's exactly why I watch out for you."

Key lesson: Ana stayed calm, didn't escalate, and made it easy for Miguel to accept treatment without feeling embarrassed. With teenagers, autonomy matters — offer, don't force.

After Glucagon: What to Expect

Timeline	What Happens
0-5 min	Person is still unconscious. Stay with them, keep on their side
5-10 min	May start to stir
10-15 min	Should be waking up. They'll be groggy and confused
15-30 min	Nausea and possible vomiting (normal). Offer sips of juice when alert
30-60 min	Progressing to small food when tolerated

Key takeaways

For unconscious/seizing persons: NO food or liquid in mouth — use glucagon and call emergency services
Baqsimi is the easiest (nasal, no mixing), Gvoke is very easy (auto-injector), traditional kit is most complex
People during lows may resist help — stay calm, don't argue, speak simply
After glucagon: expect nausea/vomiting, person wakes in 10-15 min, offer juice when alert
If they don't wake within 15 minutes, a second dose may be needed — call emergency services

Quick Check: Emergency Response

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What is the FIRST thing you should do if you find someone with T1D who is unconscious?

Emergency Response & Glucagon