A client is admitted following a suspected opioid overdose. They have a respiratory rate of 6 breaths per minute, pinpoint pupils, and are barely responsive. What is the PRIORITY intervention?

OPIOID OVERDOSE is a life-threatening emergency with a specific antidote that must be administered rapidly.

The opioid overdose triad: (1) Respiratory depression (rate below 12, here 6 — severely depressed); (2) Miosis (pinpoint pupils); (3) Altered/decreased consciousness. This classic triad is diagnostic of opioid overdose even before laboratory confirmation.

Treatment: NALOXONE (NARCAN): Opioid receptor antagonist — competitively blocks and reverses opioid effects.

Dosing: 0.4-2 mg IV, IM, or intranasal; onset: IV seconds, IM/SubQ 3-5 minutes, intranasal 2-3 minutes; may need REPEATED DOSES — naloxone's duration of action (30-90 minutes) is shorter than most opioids; if opioid wears off before naloxone metabolises, the patient will re-sedate.

While preparing naloxone: Support ventilations (bag-valve-mask at 10-12 breaths/minute); oxygen; position supine; call for resuscitation support.

After naloxone: Patient may wake up in opioid withdrawal — agitated, diaphoretic, tachycardic, may attempt to leave; do not give additional opioids; maintain airway; continuous monitoring; repeat naloxone doses as needed.

Flumazenil: This is the benzodiazepine antidote, not the opioid antidote — do not confuse; flumazenil has numerous contraindications and is used less often.

Clinical clue: Pinpoint pupils (miosis) = opioids; mydriasis (dilated pupils) = stimulants or anticholinergics. Opioid miosis is a key distinguishing feature.