Oral Glucose Gel vs Glucose Tablets.

[NCFD18]

Hey guys, at my service we carry oral glucose gel. People don't enjoy this stuff, its a chore to get them to finish them. Well one night I had a call of a AMS, get there, and have a guy conscious but had incomprehensible speech. Found out he is a diabetic and had a D-stick of 50. Anyways soon as I found this out his wife handed me some of these Glucose tablets. He ate them improved fast and he enjoyed them haha. I was thinking about buying some of these for the truck since they seem more enjoyable. I'm not sure if they are less effective then the gel. I think an adult usally has to eat 4 or 5 to get there glucose levels back up but if they like them better then the gel and it is faster imo why not? Anyways what do you think and does anyones service carry these?

[Timmy]

Glucose is glucose… Doesn’t matter in what form it comes, as long as you’re getting it into them.

Normally I can get adults to take the tube but I find that giving kids a hand full of Jelly Beans works more in their favour. We use the tablets for the football players to give them energy.

[Ridryder 911]

The advantage is glucose syrup is rapidly absorbed through the buccosa membrane of the oral cavity as well as sublingual which is a direct absorption into the mainstream. Oral tablets have to be mechanically and then chemically digested in the G. I. system, which is longer and delayed response into the bloodstream.

There is a reason Glucose Syrup is carried in lieu of oral tablets... they are not the same and absorption time is not the same.

Oral tablets is designed for those with D.M. begin to feel the signs of hypoglycemia, to be able to correct before it becomes a problem.

R/r 911

[Lithium]

I was thinking about buying some of these for the truck since they seem more enjoyable. Anyways what do you think and does anyones service carry these?

Hmm, not to sound too condescending or anything, but first off, you're a paramedic and you gave PO sugar instead of IV? Why no D50?

Secondly, my service would freak if I started using supplies (especially ones that I bought myself) to give to patients instead of using what they supplied, doesn't sound like a good plan to moi.

Jacob

[melangel16]

Hmm, not to sound too condescending or anything, but first off, you're a paramedic and you gave PO sugar instead of IV? Why no D50?

Jacob

Just a note - PCP's in Ontario (in most services anyways) can't start IV's therefore we cannot give D50 - only oral. Don't know where this took place, but just so you know - not everyone who is a paramedic can start IV's - depends on where you work.

[Ridryder 911]

[quote="Lithium Hmm, not to sound too condescending or anything, but first off, you're a paramedic and you gave PO sugar instead of IV? Why no D50?

Secondly, my service would freak if I started using supplies (especially ones that I bought myself) to give to patients instead of using what they supplied, doesn't sound like a good plan to moi.

Jacob

[emt322632]

Granted most protocols state that a patient with a low D-stick buys themself an IV of D50 or IM glucagon, but like Rid said, if they're alert enough to speak and swallow, why waste the time searching for a vein or readying the glucagon when it's so much easier to administer a tube of glucose or a glass of OJ.

As for the tablets vs. gel, everything I would have said has already been said lol...gel faster acting than tablets...I myself prefer the cherry flavored vs the lemon though lol...

[NCFD18]

Granted most protocols state that a patient with a low D-stick buys themself an IV of D50 or IM glucagon, but like Rid said, if they're alert enough to speak and swallow, why waste the time searching for a vein or readying the glucagon when it's so much easier to administer a tube of glucose or a glass of OJ.

As for the tablets vs. gel, everything I would have said has already been said lol...gel faster acting than tablets...I myself prefer the cherry flavored vs the lemon though lol...

Yeah, If somone is alert and can swallow give them glucose PO. As paramedics we should choose the least invasive procedure first. Thats terrible medics in some places can't start a line. Is there a reason for this? I also figured that the gel was absorbed quicker in the mouth that was kinda the question I had and the answer I was looking for thx.

As far as Glucose gel flavors we have at my service i've seen the ocassional cherry. Majority of the time all we have is the lemon thus the chore of getting a person to finish them. I don't even know why they make the lemon. I've never heard of anyone liking them haha. I think the tablets seem easier faster to get down. Just wanted to see what you guys think. Thanks for the input.

[zippyRN]

Hmm, not to sound too condescending or anything, but first off, you're a paramedic and you gave PO sugar instead of IV? Why no D50?

Secondly, my service would freak if I started using supplies (especially ones that I bought myself) to give to patients instead of using what they supplied, doesn't sound like a good plan to moi.

Jacob

first line treatment for a diabetic with an intact gag reflex is oral glucose ...

unless of course you are in a position to bill for 'ALS' services where every patient must recive the obligatory IV line...

then of course is the issue of

1. IV cannula / insertion technique related complications (infection, thromobphlebitis , nerve damage, risk of vascular structure damage)

2. the side effects of 50% dextrose ( e.g. risks of extravasation and local reactions to this highly hypertonic solution

3. the fact that you've messed up a big vein for days to weeks even if there are no problems

hierarchy of interventions

- oral sugars, then carbs and consider discharge at scene

- Glucagon IM , then oral sugars then carbs , consider transport

- IV glucose and transport

[scratrat]

Just another note. You shouldn't be using either one if the pt cannot follow commands (which everyone already knows) but you should NEVER be administering tablets of that size to ANY pt. Do you realize the litigation you just opened yourself up to when the pt chokes on that tablet? :shock:

Yes, I know the possibility of aspiration also comes with the gel, but I'd rather aspiration than choking to death!