In an adult experiencing hypoglycemia with no IV access, what is the glucagon dose and route?

• A. 1 mg IM/SC/IN
• B. 1 mg IV/IO
• C. 0.03 mg/kg IM/IN
• D. 0.5 mg nebulized

Answer: (A)

When treating hypoglycemia in an adult without IV access, use glucagon via a non-IV route at a fixed 1 mg dose. This route options—intramuscular, subcutaneous, or intranasal—provide rapid glucose mobilization without the need for an IV line.

Why this dose and route are best: in adults, the standard approach is a single 1 mg dose given by a non-IV route to quickly raise blood glucose when IV access isn’t available. Using IV/IO would require obtaining access first, which isn’t possible here. A weight-based dose like 0.03 mg/kg is not used for adults in this scenario, and a nebulized 0.5 mg dose isn’t a standard EMS option for this indication.

So, the most appropriate choice is a 1 mg dose delivered IM, SC, or intranasally.