Morphine titration — DipIMC MCQ

Correct answer: E — Small titrated IV morphine doses with monitoring

Option E is correct because Intravenous morphine titrated to effect is first-line analgesia for major traumatic pain when IV access is available and the patient is haemodynamically stable. A large untitrated bolus increases the risk of respiratory depression and hypotension. Reassessing pain, respiratory rate, blood pressure and sedation score after each dose is the safe pre-hospital habit. Option A is less appropriate because that dose is an ALS cardiac-arrest dose and is unsafe for this non-arrest indication; option B is less appropriate because aspirin is useful in ACS but inappropriate for this presentation. Option D is less appropriate because untitrated opioid dosing can cause avoidable hypotension or respiratory depression; option C is less appropriate because steroids have delayed onset and should not replace the immediate treatment. 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