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SUMMARYHypoglycaemia remains a serious and much feared complication of insulin therapy. In this study, patients attending an accident and emergency department in hypoglycaemic coma were randomized to treatment with either intravenous dextrose (25g) or intramuscular glucagon (lmg), administered into the right thigh. Restoration of normal conscious level was slower after glucagon than dextrose (90 vs 30 min, P<0-01), although the average duration of hypoglycaemic coma was 120 min. Two patients in the glucagon-treated group, who failed to show satisfactory recovery after 15 min, required additional treatment with intravenous dextrose. On questioning following recovery, all except two patients reported loss of awareness of the onset of hypoglycaemia.Intramuscular glucagon is valuable in the treatment of severe hypoglycaemia outwith hospital and, although the slightly slower and less predictable recovery may appear to make it a less attractive option than intravenous dextrose in the accident and emergency department, this must be balanced against the advantages of ease of administration and a lower incidence of serious adverse effects.

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Retrospective analysis showed that 67 children had presented in Edinburgh with needlestick injuries on 70 occasions over five years. Worryingly, 10 children sustained injuries pretending to be intravenous drug abusers. Despite risks of hepatitis B and HIV infection, protection and follow up were inadequate. Publicity about discarded needles and a treatment plan for use in accident and emergency departments are recommended. (Arch Dis Child 1994; 70: 245-246) Needlestick injuries have been studied almost exclusively in the context of adults at work. With large numbers of intravenous drug abusers in the community, however, many carrying the hepatitis B virus and infected with HIV, there is a pool of potentially dangerous needles circulating outside hospital.1 We investigated the circumstances, frequency, and treatment of children attending hospital after sustaining needlestick injuries. MethodsWe reviewed the case notes of children treated for needlestick injuries in the two accident and emergency departments in Edinburgh which treated children under 13 years

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