What is a common alternative treatment to IV access for severe pediatric hypoglycemia?

• A. Intramuscular or intranasal glucagon for hypoglycemia when IV access is not possible or impractical.
• B. Oral sugar crystals only.
• C. Intravenous fluids.
• D. Inhaled insulin.

Answer: (A)

When IV access is not readily available in a child with severe hypoglycemia, giving glucagon by a non-IV route is a standard, rapid rescue option. Glucagon works by signaling the liver to release stored glucose, so blood glucose rises quickly—often within minutes—even without IV access. Intramuscular and intranasal forms are particularly useful in prehospital care because they’re fast, easy to administer, and don’t require needles or establishing an IV.

Oral sugar can be considered if the child is awake and able to swallow safely, but in severe cases with altered consciousness, risk of aspiration makes oral therapy unreliable. Intravenous fluids don’t directly raise blood glucose quickly enough for a life-threatening hypoglycemia, and inhaled insulin would worsen the situation by lowering glucose.