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Free NREMT practice questionsFree AEMT practice questions · Medical/Obstetrics/Gynecology

1 free AEMT practice questions: Opioid Overdose

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Question 1 of 1

An AEMT gives naloxone to a 27-year-old patient found with pinpoint pupils and respirations of 6 per minute. The patient's breathing improves to 14 per minute and the color returns, but the patient remains sleepy and does not open the eyes. What should the AEMT do?

Show the answer and rationale

Correct answer · Stop dosing and keep watching the patient's respiratory rate during transport

This patient had respiratory depression from an opioid, and the naloxone has fixed the breathing. The pupils were pinpoint and the breathing was 6 a minute. After naloxone, the breathing is 14 a minute and the color is back. The goal of naloxone is adequate breathing, not a patient who is awake and talking. More naloxone past that point brings on agitation and acute withdrawal. Extra naloxone does nothing more for the breathing. An agitated patient in the back of the ambulance is harder to keep safe than a sleepy patient who is breathing well. Naloxone often wears off before the opioid does, and the breathing can slow down again. Keep watching the respiratory rate during transport. Repeat the naloxone per protocol if the rate drops.

Why the others are wrong

Give a repeat dose until the patient is awake and answering questions: A patient who is awake and answering questions is easier to assess. Waking this patient all the way up brings on withdrawal and agitation. The breathing is already fixed at 14 with good color, and more naloxone adds nothing to the breathing.

Give the rest of the dose so the effect lasts longer than the opioid: Naloxone wearing off before the opioid is a real risk. Giving more now does not make the naloxone last longer. More naloxone deepens the reversal and brings on withdrawal sooner. The answer to that risk is watching the breathing and repeating the dose per protocol if the breathing slows.

Stop dosing and support a refusal if the patient stays this stable on scene: Patients who wake up after naloxone often want to stay on scene, and this patient looks stable. Naloxone often wears off before the opioid does, and this patient could stop breathing after you leave. A refusal after naloxone is a high risk refusal. A refusal like this needs a careful capacity assessment and real documentation, and this patient should be transported.

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