Oral Glucose

Step-by-Step Procedure

Protocol steps for oral glucose:

AHA ACLS cardiac arrest algorithm: CPR then rhythm check then shock if VF/pVT then epinephrine q3-5min then amiodarone

Overview

Glucose paste administered by EMTs for conscious hypoglycemic patients with intact gag reflex. Oral glucose indications and contraindications tested on EMT exam.

In prehospital assessment, GCS reference range: adult 15 is normal, under 8 = severe TBI, pediatric modified pediatric GCS for preverbal. Deviations from these norms guide treatment decisions in the field.

Related Procedures

Procedures related to oral glucose in the EMS setting:

1. Trauma assessment: scene safety then MOI then primary survey (XABCDE) then rapid transport then secondary survey en route
2. Sepsis recognition: qSOFA of 2 or more (altered mentation, RR 22+, SBP 100 or less) then IV fluids 20 mL/kg then early antibiotics if ALS

Troubleshooting

Troubleshooting oral glucose in the field:

• BVM: If bag-valve-mask for manual ventilation fails, verify connections, check battery, try alternate equipment. Available sizes: Adult (1500mL), Pediatric (500mL), Infant (250mL)
• Waveform capnograph: If measures end-tidal co2 continuously with waveform display fails, verify connections, check battery, try alternate equipment. Available sizes: Mainstream (inline), Sidestream (sampling)
• Pulse oximeter: If measures spo2 via infrared absorption through capillary bed fails, verify connections, check battery, try alternate equipment. Available sizes: Finger clip, Earlobe, Pediatric wrap

Documentation

Documentation of oral glucose in the patient care report (PCR) must include: time of assessment, findings, interventions performed, patient response, and reassessment findings. Use objective, measurable terms like "patient reports 8/10 chest pain" rather than "patient in pain." Document pertinent negatives. All medications administered must include drug name, dose, route, time, and patient response.