Pengenalan Dini Syok Hipovolemik Pasien Trauma: Tinjauan Sistematis Pengambilan Keputusan Klinis Perawat Gawat Darurat
Keywords:
deteksi dini, pengambilan keputusan klinis, perawat gawat darurat, syok hipovolemik, traumaAbstract
Trauma merupakan salah satu penyebab utama morbiditas dan mortalitas global, dengan syok hipovolemik diakui sebagai penyebab kematian yang dapat dicegah, terutama akibat perdarahan yang tidak terkontrol. Deteksi dini pada fase awal pascatrauma menjadi krusial dalam meningkatkan peluang keselamatan pasien. Tanda klinis awal seringkali bersifat subtil, dan parameter vital konvensional belum mampu merefleksikan secara akurat kehilangan volume intravaskular yang signifikan. Keterbatasan ini menegaskan pentingnya peran perawat gawat darurat sebagai garda terdepan dalam pengenalan dini dan pengambilan keputusan klinis. Tinjauan literatur sistematis ini bertujuan mensintesis bukti terkait strategi deteksi dini syok hipovolemik pada pasien trauma serta mengeksplorasi kontribusi perawat dalam mendukung pengambilan keputusan klinis. Penelusuran dilakukan melalui basis data Scopus menggunakan kata kunci “hypovolemic shock” menghasilkan 27 studi yang memenuhi kriteria inklusi dari total 7.932 artikel dari tahun 2015 hingga 2025. Hasil kajian menunjukkan bahwa deteksi dini memerlukan pendekatan multidimensional yang mengintegrasikan parameter fisiologis, indeks klinis, biomarker biokimia, serta alat diagnostik cepat seperti Shock Index, Modified Shock Index, kadar laktat serum, dan point-of-care ultrasound. Temuan juga menegaskan bahwa perawat memiliki peran strategis melalui pemantauan berkelanjutan, interpretasi tanda peringatan dini, serta eskalasi penanganan secara cepat. Penguatan kompetensi, akses terhadap alat berbasis bukti, dan dukungan terhadap keputusan klinis berbasis keperawatan menjadi faktor kunci dalam meningkatkan luaran pasien trauma.
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