What is the recommended treatment for hypoglycemia during arrest?

• A. Administer IV dextrose if hypoglycemic; monitor glucose and treat accordingly.
• B. Administer oral glucose only
• C. Give glucagon and avoid IV glucose
• D. Delay glucose administration until ROSC

Answer: (A)

When glucose is critically low during an arrest, the priority is to restore circulating glucose quickly because the heart and brain rely on it for energy during resuscitation. The best approach is to give intravenous dextrose right away (for example, a bolus of 25 g of 50% dextrose) and then recheck blood glucose, treating further as needed. Oral glucose isn’t appropriate here because the patient may be unconscious or unable to protect the airway, and aspiration is a real risk. Glucagon is an alternative if IV access isn’t available, but it’s slower and less reliable in this setting. Delaying glucose until ROSC is not advisable, since ongoing hypoglycemia can worsen outcomes. After ROSC, continue to monitor glucose and manage it to maintain safe levels.