FIELD REFERENCE
Full criteria & treatment guidance
Indications
- Suspected hypoglycemia in a responsive patient able to swallow/protect the airway, under the applicable ALS or SO-B-003 BLS pathway.
Contraindications & local exclusions
- Do not give oral glucose to an unresponsive patient or one unable to swallow/protect the airway. SO-B-003 requires an intact gag reflex. An ingredient-specific commercial-product exclusion list is not established by these protocols.
Precautions
- Avoid aspiration; reassess mental status and vitals. ALS must be present/responding for the BLS pathway. Do not substitute the oral product for IV D10 or injectable glucagon instructions.
- These are selected safety checks, not a complete prescribing monograph. Product labeling and OCEMS authorization answer different questions; confirm the actual product, patient population and applicable order.
Check before giving
- Do not administer to an unresponsive patient, a patient who cannot swallow, or one without a gag reflex.
- Monitor for gagging, choking, drooling, or uncontrolled coughing and support the airway as needed.
Use in OCEMS
- Used for hypoglycemia when the patient can safely take an oral preparation.
- ALS and BLS thresholds differ slightly; use the standing order that matches the patient and your scope.
Adult / adolescent
| Indication / route | Dose & limits |
|---|---|
| ALS hypoglycemia | I-15 lists glucose at or below 60 mg/dL, or 61–80 with symptoms. Give an oral product as tolerated only if airway reflexes are intact. |
| BLS gel / paste | SO-B-003: small portions between cheek and gum on each side, until the tube is empty. |
| BLS solution / tablets | Small amounts of solution until the product is given, or two chewable tablets per SO-B-003. |
Pediatric
- Pediatric condition orders permit oral glucose only when tolerated and airway reflexes are intact; use their glucose threshold.
- SO-B-003 specifies one tablet for children younger than 12 instead of the two-tablet amount. It does not specify grams per tablet; use the exact product, not an invented gram conversion.
Pediatric dose by age / weight
- SO-B-003 tablet pathway: the patient must tolerate oral administration and have intact airway reflexes. OCEMS does not specify a tablet strength; verify the actual product.
| Age / weight | Dose basis | Amount |
|---|---|---|
| Child younger than 12; any weight | Fixed tablet count | 1 tablet; do not invent a gram dose |
| Age 12 or older; any weight | Use the applicable SO-B-003 product instructions | Review the adult/adolescent section |
Preparation & reassessment
- Confirm the medication is intended for oral administration. Concentrations and package sizes vary.
- BLS: ensure ALS is responding/present; reassess mental status and vital signs at 5 minutes and every 5 minutes until ALS arrival. Record product and amount.
UNDERSTAND THE CARE
Why oral treatment depends on continuing airway safety
The route requires active reassessment while medication is given. A patient who initially tolerates gel may later cough, gag or become less responsive. Check the local criteria and observe swallowing and airway protection instead of treating oral administration as inherently low risk.
Applying the guidance
Gel, solution and tablets have distinct instructions. The BLS tablet count does not specify grams per tablet, so the product must be identified rather than assigned an invented strength. Record the amount actually taken, administration time and response. Continue the required BLS reassessment schedule and ALS involvement.
Diagram text & teaching checkpoints
- Eligibility
- Clinical criteria and scope.
- Airway
- Responsive, swallowing and intact reflexes.
- Product
- Gel, solution or specified tablet instructions.
- Reassessment
- Mental status, vital signs and safe tolerance.
Sources for this explanation
Original OCMedic teaching synthesis of the references below. Educational expansion updated ; this is not a new independent clinical-review date. Source-specific dates and limitations remain in the full guidance.
Reassess the route while the patient takes it
The airway check is ongoing. A patient’s ability to take the first portion does not prove that the remainder can be given safely. Observe for the specific problems named by SO-B-003, including choking, gagging, drooling or uncontrolled coughing, and maintain airway support and suction as indicated.
For example, a patient initially responds and accepts small portions but becomes less responsive during administration. Do not continue merely to finish the tube or the expected tablet count. Reassess airway protection, provide the indicated support and continue ALS involvement under the BLS order. Document how much was actually taken rather than assuming the full package was administered.
Keep the exact product with the record. The tablet-count instruction does not specify grams per tablet, so there is no defensible gram total without knowing the product. At handoff, include initial findings, actual amount and time, tolerance, mental-status and vital-sign reassessments, and any interruption or airway concern.
Source: Glucose Oral Administration.