In ICEMA standing orders, what is the recommended route for glucagon administration when IV access is not available?

• A. Intravenous
• B. Subcutaneous
• C. Intranasal
• D. Intramuscular Injection

Answer: (D)

When IV access isn’t available, you want a route that delivers glucagon quickly and reliably. Intramuscular injection achieves rapid and predictable absorption into the bloodstream, giving the needed rise in blood glucose without waiting for an IV line. This aligns with ICEMA standing orders that specify IM administration for glucagon in this situation, ensuring a prompt response to hypoglycemia. Other routes exist in different protocols—intranasal glucagon is an option elsewhere, but not the one defined here, and intravenous would require establishing IV access, while subcutaneous can be slower and less consistent.