Emergency care for low blood sugar in a child who takes insulin

This information is for people who may help your child with diabetes if your child is too weak or confused to treat low blood sugar. Make a copy for each of your child's caregivers.

• Make sure the child can swallow.
  1. Lift the child's head so that it will be easier for him or her to swallow.
  2. Give the child 1/2 teaspoon (2.5 mL) of water.
• If the child chokes or coughs on the water:
  1. Call 911 for emergency care immediately.
  2. Do not try to give the child food or liquid because the child could breathe them into his or her lungs.
  3. Give the child a shot of glucagon if one is available. Follow the directions included with the medicine.
  4. Check the child's blood sugar using his or her blood sugar (glucose) meter.
  5. Stay with the child until emergency help comes.
• If the child can swallow the water without choking or coughing:
  1. Give the child a liquid (juice or soda pop) from the list of quick-sugar food.
  2. Check the child's blood sugar using his or her blood sugar (glucose) meter.
  3. Wait 10 to 15 minutes.
  4. Offer the child more quick-sugar food if he or she is feeling better but still has some symptoms of low blood sugar.
  5. Check the child's blood sugar again.
  6. Offer the child a snack (such as cheese and crackers or half of a sandwich) if it is more than 30 minutes before a meal.
  7. If the child becomes more sleepy or lethargic, call 911or other emergency services.
  8. Stay with the child until his or her blood sugar level reaches 3.9 millimoles per litre (mmol/L) and stays above that for about 30 minutes or until emergency help comes.

• If the child is unconscious but not having a seizure:
  1. Call 911 for emergency care immediately.
  2. Turn the child on his or her side and make sure the airway is not blocked.
  3. Give the child a shot of glucagon if one is available. Follow the directions included with the medicine.
  4. Check the child's blood sugar level using his or her blood sugar (glucose) meter.
  5. If the child becomes more alert, carefully give him or her a quick-sugar food or liquid.
  6. Check the child's blood sugar again.
  7. Stay with the child until emergency help comes.
• If the child is unconscious and is having a seizure:
  1. Call 911 or other emergency services immediately.
  2. Get the child in a safe position, such as lying flat on the floor. Turn the child's head to the side.
  3. Do not put anything in the child's mouth.
  4. If glucagon is available, give the child a shot of glucagon when the seizure stops.
  5. Stay with the child until emergency help comes.

Author:	Merrill Hayden Carrie Henley Monica Rhodes	Last Updated: November 24, 2006
Medical Review:	Adam Husney, MD - Family Medicine Caroline S. Rhoads, MD - Internal Medicine Hanan Bassyouni, MD - Endocrinology and Metabolism Alan C. Dalkin, MD - Endocrinology
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