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Anaphylaxis — MRCEM SBA MCQ

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HardEmergency MedicineAnaphylaxisMRCEM SBAMRCGP AKTUKMLAPARA

An adult is found unresponsive after using an unknown opioid. Respiratory rate is 4/min, oxygen saturation is 78%, pupils are pinpoint and a pulse is present. What should happen immediately while emergency help is activated?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Support ventilation and repeat naloxone according to respiratory response

B is correct. Resuscitation Council UK advises immediate emergency activation, airway opening and rescue breathing or ventilation for suspected opioid overdose, with naloxone given when available and repeated according to response. Naloxone must not delay ventilation, and recurrent toxicity requires continued observation and further treatment. A does not reverse established respiratory failure. C reverses benzodiazepines rather than opioids and may provoke seizures. D is inappropriate while a pulse is present. E is insufficient because breathing is profoundly inadequate; a recovery position is appropriate only once effective breathing is restored.

Reference: Resuscitation Council UK: 2025 first aid guidelines: https://www.resus.org.uk/professional-library/2025-resuscitation-guidelines/first-aid-guidelines GMC: physician associate registration assessment content map: https://www.gmc-uk.org/cdn/documents/guide---assess-dev---para-content-map--pa----dc21953_pdf-104351674.pdf