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Opioid toxicity — SCE Acute Medicine MCQ

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ModerateToxicology and OverdoseOpioid toxicitySCE Acute Medicine

A 42-year-old woman presents with collapse, confusion or vomiting after a possible exposure. Relevant history includes medication, recreational or environmental exposure. On assessment, toxidrome features and physiological instability are present. Investigations show bradypnoea, miosis and coma after oxycodone exposure. What is the most appropriate next step in management?

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Correct answer: A — Give titrated naloxone with airway and ventilation support

The key discriminator is that bradypnoea, miosis and coma after oxycodone exposure, which makes Give titrated naloxone with airway and ventilation support the single best answer. Provide supportive care and close monitoring is less appropriate because it does not address the dominant acute risk in the vignette; Call critical care for escalation would fit a different presentation or later stage of care. Start broad-spectrum intravenous antibiotics and Arrange urgent CT imaging are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: TOXBASE; BNF naloxone