Confirm the patient can swallow, give small portions, and reassess at 5 minutes.
OCEMS source summary · Updated 2026-09-16
Use the matching product instructions
This guide covers gel/paste. SO-B-003 gives separate instructions for liquid and tablets. Follow the source for those formulations.
Check eligibility first
Altered mental status or an acute neurologic deficit, with diabetes treated by insulin/oral medication, and/or the source glucose criteria: below 60 mg/dL, or 61–80 mg/dL when hypoglycemia is suspected.
Ensure ALS is responding or present. The patient must be able to swallow and have an intact gag reflex.
Do not give oral glucose to an unresponsive patient or one unable to swallow or without a gag reflex.
Give & reassess
Confirm the product is intended for oral use.
Place small portions of gel/paste between the cheek and gum on both sides, continuing until the tube is empty.
Watch for choking, gagging, drooling, or uncontrolled coughing. Support the airway and suction when needed.
Reassess mental status and vital signs at 5 minutes, then every 5 minutes until ALS arrives.
Document the indication, administration time, route, amount, and response.
Other formulations in SO-B-003
For an oral solution, give small amounts as tolerated until the intended product amount is taken.
For chewable tablets, the source lists two tablets, or one for a child younger than 12. No gram strength is specified, so do not invent a dose in grams without checking the product.
Document the response
Record why glucose was indicated, the preparation and amount, the route, the time, and the patient’s response. Repeat the initial assessment with mental status and vital signs every 5 minutes until ALS arrives.
Maintain airway observation throughout. Improvement after sugar does not replace continued assessment or the required ALS response.