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Opioid overdose — RCPSC EM MCQ

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HardToxicologyOpioid overdoseRCPSC EM

After fentanyl exposure, a patient has RR 5/min but a pulse. BVM ventilation restores saturation. What naloxone endpoint should guide titration?

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

Reveal the answer and explanation

Correct answer: CTitrate naloxone until spontaneous ventilation is restored without precipitating full withdrawal

Explanation lettering: B = shown as A · C = shown as B · A = shown as C

A is correct: ventilation is the target, not complete wakefulness, and respiratory support continues. B precipitates avoidable withdrawal. C leaves apnea dependent on manual support. D can trigger seizures and does not reverse opioids. E is inappropriate for acute titration and can cause prolonged withdrawal.

Reference: Emergency Care BC, Opioid Poisoning—In-Hospital Management: https://emergencycarebc.ca/clinical_resource/clinical-summary/opioid-poisoning-in-hospital-management/