What is the initial action when dealing with a pediatric patient experiencing severe hypoglycemia and no IV access?

In the scenario of a pediatric patient experiencing severe hypoglycemia without IV access, giving Glucagon intramuscularly is the initial action that is prioritized. Glucagon is a hormone that helps raise blood glucose levels by stimulating the liver to release stored glucose. It is particularly effective in situations where the patient is unable to consume oral glucose or sugars due to altered mental status or unconsciousness, which often accompanies severe hypoglycemia.

Administering glucose gel orally is not advisable in this case, as it requires the patient to be conscious and capable of swallowing without the risk of aspiration. Providing sugary drinks may also pose a risk for aspiration if the patient is not alert. While preparing for IV access is an important step in managing severe hypoglycemia, the immediate priority should be to address the hypoglycemia through available means that are safe and effective, which is why the intramuscular administration of Glucagon is the correct initial response.