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Opioid overdose — DIPIMC MCQ

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ModerateMedical EmergenciesOpioid overdoseDIPIMCDipIMC

A man is found unresponsive with a respiratory rate of 4, pinpoint pupils and a discarded needle nearby. He is centrally cyanosed.

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

Reveal the answer and explanation

Correct answer: A — Support ventilation and oxygenation and give titrated naloxone

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

In opioid toxicity the priorities are to support ventilation and oxygenation and to give naloxone titrated to restore adequate breathing rather than full alertness, because a large rapid bolus (A) can precipitate acute withdrawal, agitation and vomiting. Flumazenil (E) is for benzodiazepine, not opioid, toxicity. Remember that naloxone is short-acting, so re-narcotisation must be anticipated.

Reference: JRCALC Clinical Guidelines