Pt presents to the ER with trauma to left arm with multiple foreign bodies, swollen and appeared to be in infected. He told the CRNA he wanted a local and wanted to stay awake during the procedure.

What would you do?

Say ok and give him a local anesthetic?
Not in the pt's best interest for a LA and give him GA with RSI?
Beir Block with nessicaine?

This was a test question and I would like to see what you guys wold do in RL. I thought it would be ok to give the local. Most of my classmates said to give GA with RSI b/c he is a trauma and onsidered a full stomach, and therefore should be a RSI.