In an unconscious adult patient discovered with severe hypoglycemia (capillary blood glucose 32 mg/dL) in an outpatient clinic with no intravenous access established, which medication should be administered immediately?
Answer and explanation
Correct answer: A. Intramuscular or subcutaneous injection of 1 mg Glucagon
- Step 1: Severe hypoglycemia with altered consciousness precludes safe oral administration due to acute aspiration risk.
- Step 2: When intravenous access is unavailable, intramuscular Glucagon (1 mg) or intranasal glucagon is the first-line emergency intervention to stimulate rapid hepatic glycogenolysis and elevate blood glucose.
Answer
Intramuscular or subcutaneous injection of 1 mg Glucagon.
Why not the others: Oral intake in an unconscious patient carries high risk of pulmonary aspiration; insulin lowers blood glucose and would be fatal; epinephrine is not first-line for hypoglycemia.
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