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Opioid Overdose — RACP Adult Medicine MCQ

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EasyEmergency MedicineOpioid OverdoseRACP Adult Medicine

A 25-year-old man is brought to the emergency department after a seizure. He has pinpoint pupils, respiratory rate of 6/min, and a GCS of 5. Track marks are noted on his arms. SpO₂ is 72%. What is the most critical immediate intervention?

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Correct answer: E — Bag-mask ventilation and airway management

In opioid overdose with severe respiratory depression and hypoxia, airway management and assisted ventilation take immediate priority over naloxone. Bag-mask ventilation corrects life-threatening hypoxia while naloxone is being drawn up and administered. Naloxone (initial dose 400 mcg IV, titrated to respiratory rate, repeated every 2–3 minutes) is then given but should not delay basic airway management.

Reference: eTG – 2025 – Toxicology; ARC – 2024 – Advanced Life Support Guidelines