PEBC MCQ Diabetes, Thyroid, Bone & Hormones question: unconscious and cannot swallow

PEBC MCQDiabetes, Thyroid, Bone & Hormones

The husband of NM, 67, who uses insulin, calls the pharmacy: she is unconscious and cannot swallow, and her glucose meter reads 2.1 mmol/L. They have a glucagon kit at home. What should he be told to do?

a. Give glucagon 1 mg IM or SC, call 911, and give nothing by mouth
b. Rub honey or glucose gel inside her cheek and call back in 15 minutes
c. Call 911 and wait for paramedics before giving any treatment
d. Give glucagon 0.5 mg now and repeat 0.5 mg if she is not awake in 15 minutes

Show the answer and explanation

Answer: a. Give glucagon 1 mg IM or SC, call 911, and give nothing by mouth

In severe hypoglycemia with an unconscious person, Diabetes Canada recommends glucagon 1 mg subcutaneously or intramuscularly (or nasal glucagon 3 mg where available) and calling emergency services. Nothing should be given by mouth, including buccal gel or honey, because of choking and aspiration risk. The 0.5 mg glucagon dose is for young children, and waiting for paramedics before giving available glucagon delays treatment that the family can give safely. Once awake and able to swallow, she should eat. Source: Diabetes Canada CPG, ch. 14 Hypoglycemia (Can J Diabetes 2018;42:S104); glucagon for injection product monograph (DPD, checked 2026).

Common mistake

Giving oral fluids to an unconscious person with hypoglycemia.

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