If an adult has a blood glucose level of 3.0 mmol L⁻¹ and no IV/IO access is available, when is oral glucose indicated?

Oral glucose is indicated when a patient has a diminished level of consciousness but is still sufficiently alert to protect their airway and swallow safely. A GCS (Glasgow Coma Scale) score of 14 indicates that the patient is awake, responsive, and has only minor confusion, which means they can likely manage oral glucose without significant risk of aspiration or airway compromise.

While a higher level of consciousness allows for the safe administration of oral glucose, lower GCS scores indicate more significant impairment of consciousness, which could put the patient at risk for choking or further complications. Therefore, a GCS score of 14 strikes the right balance, allowing for treatment while ensuring the patient can respond appropriately to the administration of oral glucose.