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Opioid overdose — MCCQE Part 1 MCQ

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EasyPoisoning/OverdoseOpioid overdoseMCCQE Part 1

31-year-old man presents with found unresponsive. RR is 6/min, pupils are pinpoint and oxygen saturation is 82%. Which of the following is the most appropriate next step?

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Correct answer: C — Support airway/ventilation and give naloxone titrated to breathing

Support airway/ventilation and give naloxone titrated to breathing is best because respiratory depression with miosis suggests opioid toxicity. Wait for confirmatory testing before any stabilisation is suboptimal because resuscitation and time-critical treatment should not wait when instability is present; Discharge once symptoms temporarily improve is suboptimal because temporary improvement can precede deterioration; Give an adjunctive medication as the sole first-line treatment is suboptimal because adjuncts do not replace definitive stabilisation; Delay escalation until cardiac arrest or respiratory failure occurs is suboptimal because early escalation is central to emergency care. Ventilation is as important as naloxone.

Reference: Canadian opioid overdose guidance