What is the glucagon dose for a pediatric patient weighing more than 20 kg when IV access is not available?

• A. 1 mg IM (>20 kg)
• B. 0.5 mg IM (<20 kg)
• C. 0.25 mg IM
• D. 2 mg IM

Answer: (A)

When IV access isn’t available, glucagon is given to raise blood glucose quickly by triggering hepatic glycogen breakdown. In pediatric dosing, it’s based on weight. For a child weighing more than 20 kg, the appropriate intramuscular dose is 1 mg. This higher dose ensures a reliable rise in glucose in larger children, whereas smaller children (under 20 kg) receive 0.5 mg IM to achieve effect without excess. Administer the IM injection, monitor for an improvement in glucose and mental status, and pursue IV dextrose if/when IV access becomes available.