Is the problem not one of propofol obtunding the airway far more than midazolam and the other drugs. (except sux - which does a pretty good job - if a tad alarmingly for the awake patient!) I agree however when you state that when you are already possessed of advanced airway skills then it might be fairly safe. My own feeling is that too often procedures are attempted in A/E when the patient is - anesthetically speaking - light. In my opinion you're either getting an anesthetic or your not. So why not use anaesthetic drugs ? There's no magic to it, you just need to be confident and used to using them. Iain __________________________________________________ Do You Yahoo!? Yahoo! Shopping - Thousands of Stores. Millions of Products. http://shopping.yahoo.com/