Every year we attend a mandatory CME with our base hospital where we practice IO's on chicken bones and Portex surgical airways on pig tracheas! All fun, although I have never had to place an IO on a pt (yet) I don't think that it would deter me from one attempt if it was indicated. Is there any mechanism in your service to request additional training, or to suggest CME topics? In Canada an Advanced Care Paramedic is equivalent to the EMT-P level...