Which situation would contraindicate oral glucose administration in the field?

• A. The patient is conscious and can swallow safely
• B. The patient has signs of hypoglycemia
• C. The patient is unable to swallow safely
• D. The patient is alert with normal mental status

Answer: (C)

Oral glucose is given to someone who is conscious and able to swallow, because it acts quickly to raise blood glucose while keeping the airway protected. The only situation that contraindicates giving oral glucose in the field is when the patient cannot swallow safely or cannot protect their airway, since this creates a real risk of aspiration. If the patient cannot swallow, do not give oral glucose and instead use alternative methods such as IV dextrose or glucagon. In contrast, a patient who is able to swallow and is experiencing hypoglycemia, or an alert patient with normal mental status, remains appropriate for oral glucose therapy. The critical point is ensuring the patient can swallow without risk of choking or aspiration.