There is a quick memory aid that will help you remember how much dextrose to give to patients with hypoglycemia. It is commonly known as the 5/2/1 rule, or the rule of 50.

D10  5 mL/kg

D25  2 mL/kg

D50  1 mL/kg

Note that all three, when multiplied, equal 50 (e.g. 5ml/kg x 10 = 50)

Given the hypertonicity of D50 it can be dangerous to give through a peripheral IV. It can cause phlebitis and thrombosis and in pediatric patients it is rarely indicated, especially when D10 or D25 (in bigger kids) will work just as well. To make D25% from an ampule of D50% you discard 25 ml out of one ampule of D50, then draw 25 ml of NS or sterile water into the D50 amp. To make D10% from an ampule of D50% discard 40ml out of one ampule of D50, then draw 40ml of NS or sterile water into the D50 amp. Agitate the syringe to mix the solution. Inpatient and ED settings may have readily available D25% or D10% solutions.

In general a low glucose is < 60mg/dl or <40mg/dl in neonates. If the child is awake, alert and appropriate then give oral glucose (juice, ice cream, cake frosting, or breast milk/formula for neonates)

References

Mathew P, Thoppil D. Hypoglycemia. [Updated 2021 Jan 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534841/