شاب عمره ٢٤ سنة وصل الطوارئ فاقد الوعي، تنفسه ٦ في الدقيقة، وحدقتاه ضيقتان جداً. وجدوا معه إبرة. ما الإجراء الأول بعد تأمين مجرى الهواء؟

A 24-year-old man arrives unconscious with RR 6/min and pinpoint pupils; a syringe was found with him. After securing the airway, what is the first action?

1. Give naloxone and support breathing
2. Give thiamine then IV glucose
3. Give IV flumazenil
4. Give oral activated charcoal

Answer: A) Give naloxone and support breathing. Respiratory depression with pinpoint pupils indicates opioid overdose; naloxone reverses it but is short-acting, so re-sedation is watched for.