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Opioid overdose — MCCQE Part 1 MCQ

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EasyPoisoning/OverdoseOpioid overdoseMCCQE Part 1

A 28-year-old man is found unconscious in a public washroom with slow respirations, pinpoint pupils, and oxygen saturation 82%. A friend reports fentanyl use. What is the most appropriate next step in management?

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Correct answer: B — Support ventilation and give naloxone

Respiratory depression with miosis after fentanyl exposure is opioid overdose; airway support and naloxone are urgent. Flumazenil treats benzodiazepine toxicity and can precipitate seizures in mixed overdoses. Activated charcoal is unsafe without airway protection and does not reverse respiratory failure. Waiting for toxicology delays lifesaving treatment.

Reference: Canadian opioid overdose response guidance; CRISM OUD guideline