When is oral glucose appropriate under ICEMA standing orders?

• A. For a conscious patient who can swallow safely and has signs of hypoglycemia
• B. For an unconscious patient
• C. For any patient with suspected hypoglycemia
• D. For a patient unable to swallow

Answer: (A)

Oral glucose is used only when the patient is awake and able to swallow safely. In this state, a rapid-acting carbohydrate can be absorbed quickly to raise blood glucose and relieve hypoglycemic symptoms. It should not be given to someone who is unconscious or cannot swallow, because of the risk of aspiration and airway protection concerns. When the patient cannot swallow or is unresponsive, IV dextrose or glucagon is the appropriate route under ICEMA standing orders. So the best fit is a conscious patient who can swallow safely and is showing signs of hypoglycemia.