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In my very limited experience and exposure to such events I’m probably not the best person to give feedback… I think IO is gaining in popularity and seems to be seeping into more and more practitioners scope of practise, fantastic tool when things are going down hill quiet rapidly. I think we need to paint a better clinical picture here, was gaining a peripheral or central line not available at the time? Poly pharmacy overdoses can sometimes dehydrate quiet quickly making peripheral cannulation quiet challenging. Every case is different and I wasn’t on scene but if the patient is ?maintaining a patent airway or even had adequate perfusion with ventilation and had an output, I think I’d be more incline to go with an IVC or CVC and use IO as a fallback. I’ve only witnessed IO used as a last restore in a resuscitation case were peripheral access was challenging secondary to sever dehydration, I’m also aware IO may be indicated and the access of choice for paediatrics patients in some strife. IO is quiet out of my depth and I really haven’t researched it much but I’m guessing the onset and peak of medication though an IO may be slightly faster than a medication administered through an IVC due to direct diffusion into the medullary canal and coming into contact with the red blood cells, of course Naloxone is hepatically metabolised so it may just be faster to give the medication into the venous supply.

On this patient I most likely woldn't have done an IO. There's too many ways to give Narcan that would work. You could give IN or IM and get good results. How was her respiratory pattern? If it was adequate I would have just left her alone and only given narcan to stop respiratory depression, not bring her completely awake.

This may explain why back in my banking days, I found one of the personal banking managers and a teller in the vault.... giving a whole new meaning to full service banking.... I am not convinced that EMS is any worse than a number of other professions when it comes to cheating... maybe because we are so used to discussing anything and everything under the sun, and if you can name it, someone has seen it, that we just talk about it more....