Opiate overdose — DipIMC MCQ
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Correct answer: D — Naloxone titrated to adequate ventilation
Explanation lettering: B = shown as A · D = shown as B · E = shown as D · A = shown as E
E is correct: Naloxone should be titrated to restore breathing while avoiding abrupt withdrawal and agitation. A is less suitable because antihistamine is adjunctive and must not delay adrenaline in anaphylaxis; B is less suitable because it is a common auto-injector dose rather than the adult healthcare dose; C is less suitable because a large initial opioid bolus risks hypotension and respiratory depression; 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 Guidelines; Resuscitation Council UK; NICE guidance where applicable