QuestionSBA
QuestionChoice
This is inappropriate. The patient is showing signs of opioid toxicity that must be treated. Supportive management is more appropriate for benzodiazepine overdoses that do not cause airway/respiratory compromise.
10034883
b
Supportive management only
QuestionChoice
Naloxone will be required as this is a likely opioid overdose, however, it will take time to locate, draw up, and administer this. Following the A-E approach, it is most important (assuming the airway is patent) to support this patient's breathing with a bag-valve mask connected to oxygen, until naloxone can be administered. Not doing this could lead to respiratory, and then cardiac, arrest.
10034884
c
Administer naloxone
QuestionChoice
This patient is showing signs of opioid toxicity, potentially secondary to recreational use. Following the A-E approach, it is most important (assuming the airway is patent) to support this patient's breathing with a bag-valve mask connected to oxygen, until naloxone can be administered. Not doing this could lead to respiratory, and then cardiac, arrest.
10034882
a
Bag-valve mask ventilation
QuestionChoice
This patient is showing signs of opioid toxicity, potentially secondary to recreational use. There is no mention of airway compromise in the information given. Following the A-E approach, it is most important (assuming the airway is patent) to support this patient's breathing with a bag-valve mask connected to oxygen, until naloxone can be administered. Not doing this could lead to respiratory, and then cardiac, arrest. Intubation may be considered further down the line, but is not the next best step.
10034885
d
Intubation
QuestionChoice
This patient is showing signs of an opiate overdose. Naloxone, rather than naloxegol, is used in these situations. First, however, the patient's breathing must be supported with bag valve mask ventilation.
10034886
e
Administer naloxegol
QuestionComment
I thought we intubate if the patient's GCS is <8 :(
44627
QuestionComment
They havent really given you enough to assess GCS
59299
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Acute Kinin
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Relapse Lung
QuestionComment
I thought we put people on a 15l non-rebreathe mask in a resus situation :(
51652
QuestionComment
i think the logic is it doesn't matter how much oxygen pt has if they have RR of 6
53426
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Loose Body
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Metabolism Loose
QuestionComment
:(
53636
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Tyrosine Sclerosis
Concept
Chapter
2693
6100
Clinical features following toxin ingestion in the emergency setting
Topic
199
Emergency Medicine
19380
In cases of suspected opioid toxicity, immediate bag-valve mask ventilation is crucial to support respiration and prevent respiratory arrest.
A patient is brought to the resuscitation room in the emergency department after being found collapsed on the street. No medical history is available.

On examination, they have small pupils, which are minimally reactive to light. They are rousable to pain but not to voice. The airway appears patent.

Observations:

* Heart rate: 139 beats/minute

* Blood pressure: 120/76 mmHg

* Respiratory rate: 6 breaths/minute

* Temperature: 36.8 degrees

* Oxygen saturations (room air): 89%

What is the most important next step to take?
a