OK, this is NOT what it sounds like. A few nights ago on call I was called to the ED because one of the ER docs pushed etomidate on a frail old lady for the orthopod to perform a reduction of a dislocated hip...i.e- General anesthesia in the ED. I was a bit appalled by the lack of monitoring and airway equiptment present..and what really happenned was some myoclonus, that we all know can be seen in up to 30% of pt's given etomidate....anyway, it turns out some of the orthopods have been ordering nurses to push propofol with a RT present, reducing a fracture and leaving...relying on the RELATIVE safety profile of propofol. Again, GA in the ED, just wait until that little old lady with an unknown AV mean gradient of 55 comes in and gets 75 mg of propofol...boxed. Anyway, we had a joint meeting today with the vp of the hospital, nursing and chair of the ED department. The ER physicians are relly pushing to be allowed to use these agents( propofol and etomidate), with no repsect to NPO status whatsoever( i am aware of the lack of evidence based medicine behind this in the first place, but again another topic). Well, the ER doc got all flustered, and started ranting that he would argue that ED physicians are better at crash intubations than anesthesiologists in the first place.....we all refrained from disputing him, and I have certainly seen lots of literature quite to the contrary....I could not find them earlier, and do not want to start a debate here, but does anyone have the citations off hand??? ALso, what are teh ER physicians allowed to use at you hospitals??