Reversal of benzodiazepine sedation — DipIMC MCQ

Correct answer: B — Support airway and ventilation rather than routine flumazenil

Option B is correct because Supportive airway and ventilatory care is the priority in benzodiazepine toxicity, particularly where mixed overdose or seizure history makes flumazenil hazardous. The tempting option is pharmacological reversal, but this can precipitate seizures and withdrawal in dependent or epileptic patients. Treat the physiology first: airway positioning, oxygenation, ventilation and safe transport. Option C is less appropriate because watchful waiting risks deterioration or delays definitive care; option A 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: JRCALC Guidelines; Toxbase