Paramedics have experience and knowledge of administering intramuscular glucagon as part of their formulary, and possess the necessary skills for obtaining intravenous access.
It increases the rate and strength of cardiac contraction and also bypasses the blocked receptor while activating its own G-Protein Coupled Receptor to boost cyclic AMP levels (see Figure 1). This case report examines an intentional overdose of propranolol, including paramedic pre-hospital management, and subsequent in-hospital definitive treatment involving intravenous glucagon therapy. As stated, high dose glucagon is the FIRST LINE therapy in addition to catecholamines. Current definitive treatment for these patients involves intravenous glucagon therapy, and as such, glucagon is considered both a first-line treatment and antidote in cases of symptomatic beta blocker overdose (Joint Formulary Committee, 2011 National Poisons Information Service, 2011a 2011b). Symptomatic beta blocker overdose is a relatively uncommon, but potentially life threatening condition (Sheppard, 2006 Health Protection Agency, 2010).
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