Head trauma with altered level of consciousness is a contraindication for intranasal medications.

• A. True
• B. False
• C. Not specified
• D. Only in children

Answer: (A)

This scenario tests safety of the intranasal route when the patient has head trauma and a reduced level of consciousness. Intranasal medications depend on an open nasal passage and a stable airway for safe absorption. When consciousness is impaired, the patient cannot protect the airway, increasing the risk of vomiting or aspiration if a medication is given intranasally. In addition, head or facial trauma may involve nasal fractures or basilar skull injury; in such cases, delivering medication through the nose can be harmful—there’s a concern for nasal bleeding, injury to fracture lines, or medication inadvertently entering the cranial cavity. For these reasons, intranasal administration is contraindicated in head trauma with altered LOC. Use alternative routes, like IV or IO, and ensure airway protection.