Naloxone routes of administration in EMS include which option?

• A. Intramuscular or intranasal
• B. Oral
• C. Intravenous only
• D. Subcutaneous only

Answer: (A)

Naloxone in EMS is given through routes that are quick, practical, and reliable in the field. Intramuscular injection and intranasal administration fit best because they provide rapid onset without the need for complex equipment. Intranasal naloxone absorb through the nasal mucosa, delivering medicine quickly without needles, which makes it very field-friendly. Intramuscular injection also works fast, is straightforward to administer with basic training, and doesn’t require IV access.

Oral administration is not effective for reversing opioid overdose in a timely and reliable way because naloxone has poor and highly variable absorption from the gut and undergoes first-pass metabolism in the liver. Intravenous administration is possible in some settings, but it isn’t the only or the default route in EMS, and relying on IV access can delay treatment. Subcutaneous use is less common and not the standard in most EMS protocols. So the best answer is intramuscular or intranasal.