@karimbrohi I thought those were life saving. Please come teach almost all trauma surgeons in the US!

@united Your staff at saint louis did not do this.

@united Thanks for spelling my name correctly. 🤨. About the same level of service I was treated with at DIA when you refused to let me on the flight that you had gate checked my passport and refused to try to remedy the situation

@united You literally treated me as a criminal for checking my passport

@united No I would like some type of compensation for the inconvenience

@united They did not do this. I worked an ER shift the previous night until 2am. I was treated as a problem.

@georgenh_ @ChrisRootMD Yes. EMS systems in St Louis are doing this and it’s reasonable with good training and active medical direction.

@_JaceMullen one of the best

@jducanto @_JaceMullen @AirwayLegend Too bad propofol freezes way before then. Had it happen in me once in Wyoming loading a patient into the ship at -25

@DitchDoc14 @cpatrick_89 Strong work sir. Just used a big slug of ketamine to induce a 7 year old in status after valium, phenobarb, and keppra loads who ended up having HSV meningitis.

@DitchDoc14 @EricJaegerTNG It by definition is emergent procedural sedation without consent.

@DitchDoc14 For sure. Tons of flights that happen out of convenience or no other options (ground ambulance ETA >7 hours) that are not medically warranted. It's tough for everyone right now.

@omarkandah @critconcepts But this opinion is literally implied with direct physician oversight so try again.

@michael22joseph @DanielRGerard @reverendofdoubt Thats completely different than a paramedic bringing you a patient or a flight crew picking up a patient. They are involved in that specific patient's care and are allowed to work under their scope of practice.

@DadDocGamER Yea I think residency training should take priority unless the residents on shift want to teach EMS and they make that decision

@joshmcgoo In the setting of an EM residency program, residents should always get first right of refusal.

@CSevareid @omarkandah And in the setting of an EM residency program, the senior residents are usually the best proceduralists in the ED. When's the last time your attending did an airway on their own?

If you disagree with my opinion, I encourage you to still allow them to be involved in the procedure. BVM ventilation is such a crucial life saving skill that needs practice and these can be powerful teachable moments.