How should you respond to a conscious casualty with severe hypoglycemia in the field?

• A. Give fast-acting carbohydrates if able to swallow; if unconscious or unable to swallow, follow protocol for alternate glucose administration or evacuation
• B. Inject insulin immediately
• C. Give only water
• D. Do nothing and monitor

Answer: (B)

In hypoglycemia, the priority in the field is to raise blood glucose quickly. If the casualty is conscious and can swallow, give fast-acting carbohydrates right away so glucose returns to the brain promptly. This could be in the form of glucose tablets, juice, or another quick source of sugar. If they cannot swallow or are unconscious, you switch to alternate glucose administration (such as IV glucose or glucagon per protocol) and arrange evacuation. Injecting insulin would make the situation worse by lowering glucose further, so it should never be used in this scenario. Giving only water or doing nothing does not address the immediate need to raise blood sugar and is unsafe.