If the patient is vomiting or cannot swallow, what should you do?

• A. Wait and reassess later
• B. Administer intravenous glucose immediately
• C. Do not give oral glucose; consider alternative routes and rapid transport
• D. Give more oral glucose

Answer: (C)

When a patient is vomiting or cannot swallow, you must avoid giving oral glucose. Vomiting creates a high risk of aspiration and the glucose may not be absorbed reliably, so the glucose won’t help quickly and could worsen the situation. The priority is to deliver glucose by a nonoral route and get the patient to definitive care quickly. If IV access is available, give intravenous dextrose (for example, D50W). If there’s no IV access, use an alternate method such as intramuscular glucagon and arrange rapid transport. Only after airway protection and stabilization would oral glucose be considered again. Waiting or giving more oral glucose would not be appropriate here.