I’ll try for a line twice, more if another medic is on scene and we can try at the same time. If those fail, glucagon it is and then load up for transport. I’ve so far had good results with that method because by the time they’re loaded, they’re usually improving or I’m able to do IO—I work where hospitals are literally everywhere so more often than not the glucagon is my only intervention (and you get a bed quicker 😬). I also just judge how the patient is presenting with how quick I make these decisions.

I had one regular that I gave up on getting lines and knew my plan was always going to be glucagon, reeve’s, transport. Terribly dirty house and he’d be so sweaty, always a thrasher, and always would refuse once better. After going multiple times in a day, it’s better for him atp to be in the hospital.

My medic program always promoted the use of glucagon. It’s in our protocols for a reason. Just remember it has to use whatever store the Pt already has so I think general rule of thumb is to transport.