Okay, I like Happy's blog for the most part, we have been in MASSIVE disagreements over the utilization and deployment of PA's, and NP's, but I also for the most part respect his opinion....
HOWEVER, here, I think Happy has lost it.
Trying to assert that giving propofol in a persons bedroom, and leaving 10 minutes after administration to go to the restroom, is similar to administration in an outpatient healthcare setting is just crazy. That is truly, jumping the shark.
I give propofol frequently for shoulder and hip dislocations, fracture reductions, central line placement, chest tube placement, etc. I also use etomidate, versed, and other sedatives/anesthetics. But never, unless I have airway equipment at the ready, including a laryngoscope and ET tube, and never without proper monitoring. In fact, I had to take a course on concious sedation and prove competency prior to being able to use them. Which is a GOOD thing.
These are serious drugs, and one has to have a VERY healthy respect for them. Using them in someone's bedroom is crazy. Using them, and then leaving 10 min in (which, btw, is just about when they will be awakening with propofol) to go the restroom is criminal.
But that's my opinion.