How much glucagon should be given intramuscularly to a pediatric patient weighing less than 20 kg when IV access is not available?

• A. 0.5 mg IM (<20 kg)
• B. 1 mg IM (>20 kg)
• C. 1.5 mg IM
• D. 0.25 mg IM

Answer: (A)

In this situation, dosing is based on the child’s weight when IV access isn’t available. For a pediatric patient weighing less than 20 kg, administer 0.5 mg of glucagon intramuscularly. Using the standard 1 mg/mL preparation, this is a 0.5 mL injection. This amount is enough to trigger hepatic glycogenolysis and raise blood glucose quickly while keeping the dose appropriate for a smaller child. If the child were 20 kg or more, the dose would be 1 mg IM. After giving glucagon, reassess glucose promptly and proceed with IV dextrose if IV access becomes available.