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Opioid-related cardiac arrest — DipIMC MCQ

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HardResuscitationOpioid-related cardiac arrestDipIMC

A 44-year-old man is in cardiac arrest after a witnessed opioid overdose. Bystanders started CPR; he is pulseless and apnoeic when you arrive. What is the most appropriate management?

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Correct answer: D — Start standard ALS with ventilation and compressions; give naloxone if circulation returns with respiratory depression

Once cardiac arrest has occurred, standard ALS with effective ventilation and compressions takes priority. Naloxone may be useful in opioid-induced respiratory depression before arrest or after return of circulation, but it should not delay CPR. Recovery position is inappropriate in a pulseless patient. The pearl is that reversal agents do not replace resuscitation in established cardiac arrest.

Reference: Resuscitation Council UK Adult ALS Guidelines 2025; JRCALC Guidelines 2025