52yM unknown PMH BIBEMS found minimally responsive in the field. The patient is undomiciled-appearing male found on a wet sidewalk in the rain. EMS administered 2 amps D50 IV, 2 mg Narcan IV, and 1L NS without improvement in mental status. He was seen in the ED two times in the previous month for IV heroin intoxication and was discharged after his mental status improved without intervention. On arrival he is lethargic and wet, mumbling incoherently and localizing to sternal rub and his breathing is spontaneous. EKG, CXR, POCUS of the heart are included. NCHCT was unremarkable.