In our ER we use it all the time and there is no drug I would rather use. The half life of the drug is so short that if patient becomes too sedated you can easily bag the patient until it clears enough for them to breath on their own. I love my milk of amnesia!! Obviously the goal of conscious sedation is for the patient to remain conscious, but with any meds you can never be sure how a patient will react to a med until it is given. IF this is done in an ER setting then there is someone in the room with you who is able to manage an airway.