📚 ข้อมูลอ้างอิงและแนวทางเวชปฏิบัติ (RSI Clinical Guidelines & Evidence)DAS 2024 / Society for Airway Management / PALS
Difficult Airway Society (DAS) & SAM Guidelines (2024): Plan A (Direct/Video Laryngoscopy + Bougie), Plan B (SGA/LMA rescue), Plan C (Facemask ventilation), Plan D (eFONA / Front-of-neck surgical cricothyroidotomy).
Induction Agent Selection: Ketamine 1.5-2 mg/kg IV (preferred in shock/bronchospasm); Etomidate 0.3 mg/kg IV (hemodynamically neutral); Propofol 1.5-2.5 mg/kg IV (caution in hypotension).
Paralytic Agent Selection: Rocuronium 1.2 mg/kg IV (dose for rapid onset ≤60s; preferred in hyperkalemia, denervation/burns >24h, or crush injury; Sugammadex antidote 16 mg/kg); Succinylcholine 1.5-2 mg/kg IV (rapid onset 45s; contraindicated in malignant hyperthermia or hyperkalemia risk).
Apneic Oxygenation: 15 L/min via nasal cannula during laryngoscopy significantly prolongs safe apnea time without desaturation.