78yo male with moderately severe myesthenia gravis and end stage renal disease fell off a tractor and has some limb injury. He's in the ED. Ortho wants to go now otherwise they say the guy will lose his foot. The patient is combative and drunk. A spot-check K is okay and he had HD yesterday. The surgeon thinks he'll take about 45minutes. How do you induce this guy? How do you paralyze him? Lots of succinylcholine? How much is enough? Rocuronium? How much?