Wanted to get the hive's opinion on this: Emergency case in a remote anesthesia location, middle aged patient is NPO. History significant for morbid obesity, HTN, active smoking. Airway exam: TM 4 fingers, oral excursion 2 1/2, MP IV, full range of motion. Attending, 2 senior residents present. The case requires ETT. Monitors, pre-oxygenate, induce with propofol. Grade 3 mask ventilate (2 hands, oral airway). Quickly becomes Grade 4 (unable to ventilate). LMA 3 placed with marginal but adequate TV, SpO2 stabilizes. Difficult airway cart 10 minutes away. What now?