We had a learning experience this week that we hadn't really considered before when talking about glucagon administration by "third parties" (trained to administer glucagon, but not necessarily very informed about T1 as a whole). We learned that, in some cwd's, in certain situations, dka symptoms can be easily confused with symptoms of a hypo to the uninitiated. We also learned that it was important to include a blood check, in order to confirm that he is experiencing a hypoglycemic episode, prior to the administration of glucagon in his 504 plan. Case in point. Our son was 2 hours away participating in an 800m track event. Half way though he was visibly in distress and on completion fell to the ground, was half unconscious, very confused, and lethargic. His coach promptly rummaged through the teams first aid bag, produced his glucagon, and was on his way to our son. It's rare that at least one of us can't make a meet, but luckily, his younger brother also participates in track and had the presence of mind to poke his brother before the coach got to him. He was 470. His brother was able to dissuade the coach ("you'll kill him!") from hitting him with big red, called dad, helped his brother with his novolog injection, helped him get hydrated, and got him to eat a bit. He was positive for ketones, but within a half hour was feeling better and was able to stay for the remainder of the meet (although he didn't participate in any other events). Once home, he still had trace ketones, but we were able to flush them over the next hour or so and get his bg's under control. He was sicker than a dog all night and the next day, but none worse for the wear. Long story long--- He had been feeling pretty cruddy all day and had been fighting persistent highs, but exhibiting the logic of a typical "almost 18" year old, had decided that "A", he had to stay in school that day in order to participate in the meet, "B", there was no way he was missing a regional meet, "C", he knew he was higher than we would want him to be, but since he would be physically active anyway, it would be manageable, and "D", if he didn't do a bg check when the meet started then mom and dad wouldn't be able to see he was out of range and went to the meet anyway. As for the coach, he did exactly as he had been instructed. He quickly reviewed the chart we had provided for identifying a hypo, noted that our son was semi-conscious, lethargic, sweating, confused, and was fully prepared to administer glucagon, call 911, then call dad. As for his brother, he did exactly as he has been instructed. Any time his brother is acting out of character, ask him to do a blood check, or do it for him. Granted, illness on top of dehydration on top of extreme physical exertion on top of poor judgment isn't a common occurrence, but adding a 10 second bg check prior to administering glucagon to his 504 plan doesn't seem like such a bad idea to us. I shudder to think about what might have happened if his brother hadn't been so quick on the draw to poke him.