This is not good. First off, I would imagine that radiologists are not credentialed to perform general anesthesia at your institution, and if they are, I (as an anesthesiologist) would not work at this institution. Regarding liability, you are responsible for all sedation that you direct. As I understand it, you should only be directing nurses, not CRNAs. CRNAs would either practice under their own license (opt-out state, an unlikely scenario at an academic institution) or under the direction of an anesthesiologist. I guess there could be "proceduralist direction" of a CRNA in a non opt-out state, but again this would be unusual at an academic center.
If you "moderately sedate" someone and call me in halfway through to either bail out some emergency or provide GA to get the procedure done, I am going to be pretty pissed off. In the case of an emergency, I would help manage the emergency (airway, etc), and promptly do my damnedest to get your sedation priviliges revoked. In the case of "we need more sedation to get this done" (usually after like 10 mg versed and 500 mcg fentanyl, with probably some benadryl/atarax/demerol/whatever thrown in for good measure), I would tell you to F off and do it another day when I can consent the patient for anesthesia. Your "consent" for my procedure doesn't mean ^%&* to me.
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Radiology resident consenting for general anesthesia
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