NREMT Emergency Medical Technician (EMT) Cognitive ExamPharmacologyMedium
A 30-year-old male is experiencing an opioid overdose. He is unresponsive, has shallow respirations at 6 breaths per minute, and pinpoint pupils. His family states he took 'a few pills' an hour ago. You have Naloxone available. What is the typical adult dose and route for initial prehospital administration of Naloxone via auto-injector or intranasal route?
- A5 mg Oral (PO)
- B2 mg Intranasal (IN)
- C1 mg IV
- D0.4 mg IM
Show answer & explanationAnswer & explanation
Correct answer: B. 2 mg Intranasal (IN)
For suspected opioid overdose, the typical initial dose of Naloxone for adults in the prehospital setting is 2 mg intranasally, or 0.4 mg to 2 mg intramuscularly, depending on local protocols and available formulations (e.g., auto-injector). A common and effective intranasal dose is 2 mg.
Why the other options are wrong
- A. Naloxone is not administered orally for overdose due to poor and slow absorption; it needs a rapid route for a critical patient.
- C. IV administration is often done by paramedics, not typically EMTs, and 1 mg can be a dose, but 2 mg IN/IM is more common for initial EMT reversal.
- D. While 0.4 mg IM is a common dose, 2 mg IN is also very common and often preferred for rapid administration without needles in prehospital settings, and 2 mg is a standard intranasal dose.
Naloxone Administration for Opioid Overdose
The emergency administration of an opioid antagonist to reverse the effects of an opioid overdose, primarily respiratory depression.
- Indications: Suspected opioid overdose with respiratory depression.
- Common routes: Intranasal (IN), Intramuscular (IM).
- Typical adult dose: 2 mg IN or 0.4 - 2 mg IM.
- Goal: Restore adequate spontaneous breathing.
Memory trick: Naloxone to the nose or muscle, for breath that's slow and in a tussle.