When treating a 5-year-old experiencing a seizure with suspected hypoglycaemia, what is the recommended glucose administration?

In cases of suspected hypoglycemia in pediatric patients experiencing a seizure, the administration of D10 (10% dextrose) at a dosage of 10 mL per kilogram intravenously is appropriate because it rapidly elevates blood glucose levels. This strategy is effective in a pre-hospital setting since intravenous access can be established quickly and D10 provides a balanced concentration that is safe for a child of this age, minimizing the risks associated with larger volumes or higher concentrations of dextrose solutions.

The recommendation to use D10 reflects an understanding of pediatric emergency care protocols, which emphasize the need for quick correction of hypoglycemia, especially in seizure situations. D10 is well-tolerated and reduces potential osmotic complications that might arise from using higher concentrations, such as D50.

In comparison, while glucagon can be used in cases of hypoglycemia, it is typically reserved for situations where IV access cannot be established or the patient is unconscious. D25 (25% dextrose) could also elevate blood sugar but is generally not the first line for children due to the risk of causing hyperosmolarity. Similarly, oral dextrose is not practical during a seizure, as immediate administration is not feasible and could result in aspiration