I just spoke with our er doc and he was curious as to why you wouldn't want to give it.
A couple of reasons actually,
In this scenario, the patient is neither bradycardic nor mentally altered, and there are likely other pathologies in play.
Outside of this, the Beta blocker (BB) reversal with glucagon is not always a first-line agent, though it usually is.
It is administered IV, and often with Chloride. (While fine in the hospital, that is an aweful lot of chemistry for prehospital EMS) The dosage is listed starting at 5mg IV with follow up bolus as needed and then an infusion of 9mg/hour, until the effects of the BB wear off.
Potential side effects: arrythmia (with side effects common to those), rebound HTN, induced attack of angina, N/V, worsening of baseline cardiac function.
From the practical point, most EMS agencies don't carry that kind of dose, use it IM and not IV, and even if you were to give an IV bolus, what is the likelyhood this patient would be brought into the ED and they would automatically set up a drip on your word?
Furthermore, when you are talking about an infusion over hours, the ED is not going to sit on that patient and perform serial labs.
It makes more sense for EMS to provide supportive therapy, with definitive reversal started in the ED, continued in a unit or floor, or simply admitted there to begin with and allow those people to do their job.
An arrest or peri-arrest situation would of course be a bit different, but I am thinking so rare that therapy like transcutaneous pacing or IV fluid therapy might be a but more prudent out of the hospital as well.
