Oral Glucose
Oral glucose gel is appropriate for conscious patients who can swallow and protect their airway. The usual dose is 15 grams. It is a safe first-line option for EMTs treating hypoglycemia with an altered but alert patient.
IV Dextrose
Dextrose 10 percent or 50 percent is given intravenously to unresponsive hypoglycemic patients. It acts quickly, but extravasation can cause tissue injury, so confirm a patent line. Recheck blood glucose after administration and consider repeat dosing.
Glucagon
Glucagon is given intramuscularly, usually 1 mg, when IV access is not available. It works by stimulating glycogenolysis in the liver, so it may be less effective in malnourished or alcoholic patients with depleted glycogen stores. Patients should eat once they are alert enough to do so safely.