When managing apnea in a child on IV opioids, which action is typically performed first?

• A. Administer naloxone
• B. Start chest physiotherapy
• C. Give a hydrating drink
• D. Apply cold compress.

Answer: (A)

Opioid-induced respiratory depression is an emergency that requires rapid reversal to restore breathing. Naloxone is an opioid antagonist that quickly binds to the same receptors as the opioid, displacing it and reversing the depressive effect on respiration. In a child receiving IV opioids who develops apnea, giving naloxone promptly directly addresses the cause and often restores ventilatory effort faster than other measures. After giving naloxone, continue to monitor closely and support the airway if needed, because the opioid effect can outlast naloxone in some cases and re-sedation is possible.

The other actions don’t target the underlying cause of the apnea. Chest physiotherapy won’t reverse opioid-induced respiratory depression, a hydrating drink won’t counteract the depressant effect, and a cold compress is unrelated to respiratory status.