You are working in northwest arctic Alaska and need to manage 3 critical patients at once as the solo coverage doc while arranging their transfer to anchorage, a 3 hour flight away. You only have one local flight crew and 3 sick people . . .

Tackle pediatric sedation in a solo coverage environment thinking through all of your monitoring, equipment, medications, backup, so that you can do this safely in a place where pediatric sedation is less common and respiratory therapy is not always available

No surgeon, no arterial line, no intensive care nurse, no transport for 6 hours. . .  if this situation sounds familiar or sounds like your worst nightmare, it's time to practice "Critical Access Neurocritical Care". There are many aspects of neuro ICU care that we can do extremely well to actively protect the injury and not just passively wait for transfer.