NREMT Emergency Medical Technician (EMT) Cognitive ExamPharmacologyMedium
A 25-year-old male is found unresponsive with pinpoint pupils and shallow respirations at a rate of 6 breaths per minute. He has track marks on his arms. The EMT suspects an opioid overdose. What is the appropriate initial dose of naloxone for this patient?
- A2 mg Intranasal (IN)
- B0.4 mg Intramuscular (IM)
- C0.1 mg Intranasal (IN)
- D4 mg Intramuscular (IM)
Show answer & explanationAnswer & explanation
Correct answer: A. 2 mg Intranasal (IN)
For suspected opioid overdose, the standard initial dose of naloxone for an adult is 2 mg intranasally (IN) or 0.4 mg intramuscularly (IM) and can be repeated. Many prehospital protocols now favor the 2 mg IN or 4 mg IN dose for ease of administration and rapid onset.
Why the other options are wrong
- B. 0.4 mg IM is a correct dose but the question asks for the appropriate initial dose, and 2 mg IN is a common and effective initial dose in many protocols.
- C. 0.1 mg IN is too low for an initial adult dose in an opioid overdose.
- D. 4 mg IM is an excessive single dose, though 4 mg IN is also a common initial dose.
Naloxone Dosing (Adult Opioid Overdose)
The recommended initial dose of naloxone for reversal of opioid-induced respiratory depression in adults in the prehospital setting.
- Common initial doses: 2 mg IN or 0.4 mg IM
- Can be repeated every 2-3 minutes as needed
- Goal is to restore adequate respirations, not necessarily full consciousness
Memory trick: Naloxone for Numbness: Two in the Nose, or Point Four in the Muscle!