Initial Assessment Pra Hospital pada Pasien Acute Coronary Syndrome: Systematic Review

Abstract

Beberapa studi acute coronary syndrome (ACS) sebelumnya berfokus pada intervensi edukasi atau manajemen ACS secara umum, tanpa mengulas peran kunci pengkajian awal secara sistematis dalam menurunkan morbiditas dan mortalitas. Penelitian ini bertujuan untuk menganalisis efektivitas initial assessment dalam meningkatkan respons awal dan outcome klinis pada pasien ACS di pelayanan pra rumah sakit. Tinjauan sistematis diperoleh dari lima basis data, yaitu PubMed, ScienceDirect, Google Scholar, Scopus, dan ProQuest. Kata kunci yang digunakan dalam pencarian literatur meliputi “Initial assessment”, “Pre hospital”, dan “Acute coronary syndrome”, dengan batasan publikasi antara tahun 2018–2024. Proses penelusuran awal menghasilkan 88 artikel. Eliminasi duplikasi dan penyaringan berdasarkan kriteria inklusi serta seleksi judul, abstrak, dan teks lengkap memperoleh 16 artikel yang dianalisis lebih lanjut. Penilaian kualitas artikel menggunakan instrumen dari Joanna Briggs Institute (JBI). Hasil analisis menunjukkan bahwa initial assessment yang sistematis dan tepat waktu secara signifikan meningkatkan kecepatan diagnosis, ketepatan intervensi awal, serta menurunkan angka kematian dan komplikasi pada pasien ACS. Tenaga pra rumah sakit memerlukan pelatihan berkelanjutan, standarisasi protokol penanganan, serta kolaborasi lintas sistem layanan darurat untuk meningkatkan hasil klinis secara menyeluruh. Penelitian ini merekomendasikan integrasi initial assessment sebagai bagian penting dari sistem pelayanan pra rumah sakit dan strategi manajemen kegawatdaruratan kardiovaskular.Some previous acute coronary syndrome (ACS) studies have focused on educational interventions or general management of ACS, without reviewing the key role of systematic early assessment in reducing morbidity and mortality. This study aims to analyze the effectiveness of initial assessment in improving early response and clinical outcomes in ACS patients in pre-hospital care. A systematic review was conducted on 16 articles obtained from five databases: PubMed, ScienceDirect, Google Scholar, Scopus, and ProQuest. Keywords used in the literature search included “initial assessment,” “Pre hospital,” and “Acute coronary syndrome (ACS),” with a publication range between 201 and 2024. The initial search yielded 88 articles. After removing duplicates and screening based on inclusion criteria as well as selection by title, abstract, and full text, 16 articles were included in the final analysis. Article quality was assessed using the Joanna Briggs Institute (JBI) appraisal tool. The analysis showed that a systematic and timely initial assessment significantly improves diagnostic speed, accuracy of early intervention, and reduces mortality and complications in ACS patients. Ongoing training for pre-hospital healthcare providers, standardized treatment protocols, and inter-system emergency care collaboration are essential to improve overall clinical outcomes. This review recommends integrating initial assessment as a key component of pre-hospital services and cardiovascular emergency management strategies.