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COPD exacerbation — DipIMC MCQ

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HardMedical EmergenciesCOPD exacerbationDipIMC

A patient with suspected opioid toxicity is apnoeic but has a pulse. Effective bag-mask ventilation is underway and intranasal naloxone is available. What is the treatment endpoint?

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Correct answer: B — Titrate naloxone to spontaneous ventilation while supporting the airway

The best answer is “Titrate naloxone to spontaneous ventilation while supporting the airway”. Airway opening, oxygenation and assisted ventilation are the immediate lifesaving treatments for opioid-induced apnoea. Give naloxone by an available route and repeat or titrate it toward adequate spontaneous breathing and airway protection, not abrupt complete wakefulness. Excess reversal can precipitate severe withdrawal and agitation, while naloxone may wear off before the opioid and requires continued monitoring.

Reference: UK Government, Supplying take-home naloxone without a prescription: https://www.gov.uk/guidance/supplying-take-home-naloxone-without-a-prescription