NREMT Emergency Medical Technician (EMT) Cognitive ExamPharmacologyHard
An EMT is assisting a 62-year-old female with her prescribed oral glucose for suspected hypoglycemia. The patient is conscious but disoriented and unable to follow commands to swallow safely. What is the most appropriate action for the EMT?
- AAdminister the oral glucose by placing it under her tongue.
- BAdminister the oral glucose by mixing it with water and having her drink it.
- CAdminister the oral glucose by rubbing it on the buccal mucosa.
- DWithhold the oral glucose and consider alternative interventions.
Show answer & explanationAnswer & explanation
Correct answer: D. Withhold the oral glucose and consider alternative interventions.
Oral glucose is only administered to conscious patients who are able to swallow safely and protect their airway. A disoriented patient unable to follow commands to swallow safely is at high risk for aspiration if oral glucose is administered. In such cases, alternative interventions like glucagon (if available and protocol permits) or intravenous dextrose (by ALS) should be considered, and transport initiated.
Why the other options are wrong
- A. Oral glucose is not designed for sublingual absorption; this poses an aspiration risk without benefit.
- B. Mixing with water does not mitigate the aspiration risk if the patient is unable to swallow safely.
- C. While some medications can be absorbed buccally, oral glucose gel is designed for ingestion and carries an aspiration risk if the patient cannot swallow safely.
Oral Glucose Contraindications
Conditions where oral glucose should not be administered, primarily related to the patient's ability to protect their airway.
- Unconsciousness
- Inability to swallow safely
- Known allergy to glucose
Memory trick: No Glucose If You Choke, Or Cannot Speak a Joke!