Naloxone titration — DipIMC MCQ

Correct answer: A — Use further naloxone titrated to ventilation if needed

Explanation lettering: E = shown as A · C = shown as B · B = shown as C · A = shown as D · D = shown as E

E is correct: Naloxone should be titrated to adequate breathing, not full arousal, to reduce agitation and risk. A is less suitable because a large initial opioid bolus risks hypotension and respiratory depression; B is less suitable because it is a common auto-injector dose rather than the adult healthcare dose; C is less suitable because antihistamine is adjunctive and must not delay adrenaline in anaphylaxis; D is less suitable because cardiac-arrest adrenaline dosing is inappropriate in a perfusing patient. The most tempting alternative is therefore suboptimal because it either delays the time-critical pre-hospital intervention or sends the patient to the wrong level of care. The key DipIMC principle is focused cABCDE decision-making with early pre-alert, triage or retrieval escalation when the scene physiology demands it.

Reference: JRCALC Medicines Guidelines; Resuscitation Council UK; BNF