# Glucagon

IM hypoglycemia treatment when IV access cannot be established.

Population: Adult & pediatric guidance. Scope: ALS.
Status: published. Source-linked OCEMS summary.
Summary updated: 2026-09-16.
Source checked: 2026-09-16.
Source version: I-15 revised March 31, 2026; I-20 revised March 26, 2026. Both implemented April 1, 2026. See linked condition-specific sources..
Canonical page: https://www.ocmedic.com/guides/glucagon/
Official source: [I-15 — Adult / Adolescent Standing Order Drug Guide](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/I-15%20Adult%20SO%20Drug%20Guide%2004-2026.pdf)

Independent OC Medic summary. Does not replace the complete policy, current system notices, or clinical judgment.

## Check before giving

- Do not give oral glucose to a patient without an intact swallow/airway reflex.
- If an unconscious hypoglycemic patient cannot receive IV dextrose and fails to respond to IM glucagon, check the source’s IO dextrose exception.

## Source documents

- [I-15 — Adult / Adolescent Standing Order Drug Guide](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/I-15%20Adult%20SO%20Drug%20Guide%2004-2026.pdf#page=2)
- [I-20 — Pediatric Medication Volume Dose by Weight](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/I-20%20Peds%20Drug%20Guide%2004-2026.pdf)
- [SO-M-020 — Altered Mental Status](https://www.ochealthinfo.com/sites/hca/files/import/data/files/12033.pdf)
- [SO-P-065 — Altered Mental Status - Pediatric](https://www.ochealthinfo.com/sites/hca/files/2021-12/SO-P-65%20Alterned%20mental%20status.pdf)
- [SO-P-075 — Seizure / Convulsion - Pediatric](https://www.ochealthinfo.com/sites/healthcare/files/2024-07/SO-P-75%20Seizures%20peds.pdf)
- [SO-P-080 — Shock (Symptomatic Hypotension) - Pediatric](https://www.ochealthinfo.com/sites/healthcare/files/2025-05/SO-P-80%20Shock%205-2025.pdf)

## Use in OCEMS

- A hypoglycemia option when IV dextrose cannot be given because IV access cannot be established.
- Use the glucose threshold from the patient’s applicable condition order and continue airway/ventilation support.

## Adult / adolescent

| Indication / route | Dose & limits |
| --- | --- |
| Hypoglycemia without IV access | 1 mg IM once. I-15 covers glucose at or below 60 mg/dL or below 80 with symptoms suggesting hypoglycemia. |

## Pediatric

- SO-P-065 lists 0.5 mg IM when IV access cannot be established for glucose below 60 mg/dL. The pediatric seizure, shock, and poisoning orders also list 0.5 mg.
- The pediatric dose in these OCEMS standing orders is not the adult 1 mg dose. Consult the appropriate pediatric condition order for its threshold.

## Pediatric dose by age / weight

- SO-P-065: hypoglycemia below 60 mg/dL when IV access cannot be established. Other pediatric orders have their own glucose thresholds.
| Weight | Pediatric dose | Volume / route |
| --- | --- | --- |
| Any eligible pediatric weight | 0.5 mg — fixed dose | 0.5 mL IM when reconstituted to 1 mg/mL |

## Preparation & reassessment

- The inventory includes a 1 mg vial with diluent. Reconstitute the supplied product according to its labeling and verify the resulting concentration.
- Reassess glucose and consciousness, maintain airway support, and document the clinical response.