If a seizure patient has a blood glucose level below 60 mg/dL and IV/IO access is available, which treatment should be given?

If a seizure patient has a blood glucose level below 60 mg/dL and IV/IO access is available, which treatment should be given?

• A. D10 25 g IV/IO (250 mL of 10% solution) may repeat x1 in 5 minutes
• B. Glucagon 1 mg IM for no IV access
• C. Oral glucose gel
• D. D50 25 g IV/IO

Answer: (A)

When a patient who is seizing has hypoglycemia and IV/IO access is available, the priority is to rapidly raise the blood glucose with intravenous dextrose. Giving 25 g of dextrose as a 10% solution (a D10 bolus of 250 mL) via IV or IO provides a fast, reliable correction of low glucose that can restore brain function quickly. If glucose remains low or symptoms persist after about five minutes, a repeat dose can be given. Oral glucose isn’t ideal here because the patient is actively seizing and at risk of choking or aspirating, so swallowing safely isn’t possible. Glucagon is useful when IV access isn’t available, but with IV/IO access, IV dextrose is faster and more dependable. While D50 (50% dextrose) could achieve the same goal, using D10 IV/IO minimizes osmolar risk and aligns with standard practice for rapid correction when an IV line is already in place.

When a patient who is seizing has hypoglycemia and IV/IO access is available, the priority is to rapidly raise the blood glucose with intravenous dextrose. Giving 25 g of dextrose as a 10% solution (a D10 bolus of 250 mL) via IV or IO provides a fast, reliable correction of low glucose that can restore brain function quickly. If glucose remains low or symptoms persist after about five minutes, a repeat dose can be given.

Oral glucose isn’t ideal here because the patient is actively seizing and at risk of choking or aspirating, so swallowing safely isn’t possible. Glucagon is useful when IV access isn’t available, but with IV/IO access, IV dextrose is faster and more dependable. While D50 (50% dextrose) could achieve the same goal, using D10 IV/IO minimizes osmolar risk and aligns with standard practice for rapid correction when an IV line is already in place.