NREMT Emergency Medical Technician (EMT) Cognitive ExamMedical EmergenciesMedium

A 55-year-old male is found unconscious by his family. His respirations are slow and shallow at 8 breaths per minute, and his skin is cool and clammy. His pupils are pinpoint. Family states he has a history of chronic pain and takes several medications, but they are unsure which ones. What is the MOST appropriate initial intervention for this patient?

  1. AAdminister oral glucose.
  2. BAdminister naloxone.
  3. CAssist ventilations with a bag-valve mask.
  4. DPrepare for immediate defibrillation.
Show answer & explanation

Correct answer: C. Assist ventilations with a bag-valve mask.

The patient's slow, shallow respirations indicate respiratory depression, which is a life-threatening condition regardless of the underlying cause. Assisting ventilations with a bag-valve mask is the most immediate and critical intervention to ensure adequate oxygenation and ventilation, even before administering an antidote like naloxone.

Why the other options are wrong

  • A. Oral glucose is for conscious patients with suspected hypoglycemia; this patient is unconscious and may have an opioid overdose.
  • B. While naloxone may be indicated, addressing the immediate respiratory compromise with assisted ventilations takes precedence.
  • D. There is no indication of cardiac arrest or a shockable rhythm; defibrillation is not appropriate.

Opioid Overdose Initial Management

The immediate priority in suspected opioid overdose with respiratory depression is to ensure adequate ventilation and oxygenation.

  • Respiratory depression is the primary life threat.
  • Assisted ventilations precede naloxone administration if breathing is inadequate.
  • Pinpoint pupils are a classic sign of opioid overdose.

Memory trick: Breathe FIRST, then Reverse the Dose!

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