I just want to bring up an issue I've been seeing a lot lately. In paramedic class, I learned D50 can cause tissue necrosis (death) if the IV is infiltrated (which you can't always see). I also learned that whenever you give a med (or whatever else for that matter), you always assess the risks verses the benefits of giving that med. They never went into any more detail but common sense told me to never give D50 unless you have no other choice. Why then am I seeing ALS providers giving D50 to hypoglycemic pts who are awake. I ran a decreased BGL call last week where the glucometer read 20 and the pt was awake, not quite oriented, slurring speech, slightly lethargic, all the normal stuff. I was riding double ALS and my paramedic partner wanted to give D50. I wanted to give a little oral glucose and have the pt eat breakfast. Apparently my partner didn't like that because that might take 10-20 mins instead of 20 seconds with the D50. Here is my question to ems educators--why don't these paramedics know any better? Could I be wrong? Is there some reason why we should give D50 to people who are awake and not in immediate danger?