Morphine titration — DipIMC MCQ

Correct answer: B — Intravenous morphine in small titrated boluses

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

E is correct: Opioid analgesia should be titrated in small increments with monitoring rather than given as a single large dose. A is less suitable because rapid IV benzodiazepine bolus carries avoidable respiratory risk; B is less suitable because a large initial opioid bolus risks hypotension and respiratory depression; C is less suitable because analgesia is important but does not replace the first physiological intervention; D is less suitable because antihistamine is adjunctive and must not delay adrenaline in anaphylaxis. 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