So, we almost never have patients that recieve propofol in the ED. Its gas limited other than post intubation management. Tonight, we had a really bad posterior shoulder dislocation with a wierd fracture. Ortho resident wanted it to go to the OR but because it was the weekend, several attendings told him: get gas and give propofol after aspirating the 'clot'. So, we get gas (we haven't given the guy anything as well know in this 270 lb big guy, that ketamine/versed or fentanyl/versed is just not going to cut it). They give ketamine/versed which doesn't work, the guy is hopping around and screaming. Then they give propofol (about 5 minutes after the ketamine/versed). Guy stops breathing, sat drops to 85% but he is bagged through. Not such a big deal for us but the gas attending is cussing a storm about case needing to be in the OR, intubation ,etc. Know, to some degree, we all agree. but it wasn't possible. So, anyone with experience with propofol immediately on top of ketamine/versed?