On individual days, esmolol/saline was infused from −15 to 30 minutes. In a randomized crossover study, 10 healthy men received combinations of esmolol (1.25 mg/kg bolus+0.75 mg/kg/min infusion), glucagon (50 µg/kg), and identical volumes of saline placebo on 5 separate days in random order (saline+saline esmolol+saline esmolol+glucagon bolus saline+glucagon infusion saline+glucagon bolus). Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).Paramedics have experience and knowledge of administering intramuscular glucagon as part of their formulary, and possess the necessary skills for obtaining intravenous access. This case report examines an intentional overdose of propranolol, including paramedic pre-hospital management, and subsequent in-hospital definitive treatment involving intravenous glucagon therapy. 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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