Opioid analgesia hypotension — DipIMC MCQ

Correct answer: A — Use cautious titrated analgesia with haemodynamic monitoring

Option A is correct because Analgesia remains important, but hypotension and drowsiness make cautious titration and close monitoring essential. Withholding analgesia because the patient is unstable is poor care, while large opioid doses may worsen hypotension and ventilation. In major trauma, pain management should run alongside haemorrhage control, warming and rapid transport. Option B is less appropriate because watchful waiting risks deterioration or delays definitive care; option C is less appropriate because the clinical risk exceeds that destination or timeframe. Option E is less appropriate because it is plausible in a different scenario but suboptimal for the features described; option D is less appropriate because analgesia is important but not sufficient as the primary intervention. Clinical pearl: in DipIMC-style questions, the best answer is the intervention that changes outcome earliest in the pre-hospital phase.

Reference: NICE Major Trauma NG39; JRCALC Guidelines