skip to main content

Entonox contraindication pneumothorax — DipIMC MCQ

Instant feedback + full explanation. One question, done properly.

ModeratePharmacologyEntonox contraindication pneumothoraxDipIMC

A 35-year-old with chest trauma asks for Entonox during extrication. He has unilateral reduced breath sounds and pleuritic pain after a high-speed collision. What is the most appropriate drug/dose?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Avoid Entonox and use an alternative analgesic strategy

Avoid Entonox and use an alternative analgesic strategy is the best answer because nitrous oxide can expand trapped gas and is avoided when pneumothorax is suspected. Give intramuscular morphine 20 mg as a fixed dose is less appropriate because fixed intramuscular opioid dosing is poorly titratable; Give oral medication and reassess at hospital is less appropriate because oral treatment is slow and unreliable in major trauma. Give aspirin 300 mg for traumatic pain and Withhold the drug until laboratory confirmation is available are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.

Reference: JRCALC Guidelines; ATACC Manual