Kompetensi Dokter Umum di Unit Gawat Darurat dalam Manajemen Jalan Napas: Tinjauan Sistematis dan Meta-Analisis (2015–2025)

I Kadek Adi Paramartha; Made Paramartha Kesuma

doi:10.62354/jurnalmedicare.v4i2.193

Penulis

I Kadek Adi Paramartha RS Ari Canti Gianyar
Made Paramartha Kesuma RS Siloam Denpasar https://orcid.org/0009-0003-3818-0174

DOI:

https://doi.org/10.62354/jurnalmedicare.v4i2.193

Kata Kunci:

emergency departement, airway management, competency

Abstrak

Emergency airway management is frequently performed by general practitioners in emergency departments (EDs); however, their success rates remain poorly defined. We conducted a systematic review and meta-analysis of PubMed, MEDLINE, and Google Scholar (2015–2025) for studies reporting endotracheal intubation (ETI) or supraglottic airway (SGA) placement by general practitioners or non-specialist residents in the ED. Exclusion criteria were specialist operators and surgical airway procedures. Fifteen studies (31 874 ETI attempts) were analysed qualitatively; five sufficiently homogeneous studies were pooled in a random-effects meta-analysis using first-pass success (FPS) as the effect measure. The pooled FPS for general practitioners was 75 % (95 % CI, 70–80 %; I² = 92 %). Major complications (hypoxaemia, hypotension, aspiration) ranged from 12 % to 49 % and increased significantly with each additional intubation attempt. Simulation studies showed 97 % successful ventilation with SGA placement by novice operators compared with 62 % with ETI. Determinants of success included ≥ 50 prior ETI experiences, use of rapid sequence intubation, video laryngoscopy, senior supervision, adherence to difficult-airway algorithms, and regular simulation training. ETI competency among general practitioners in EDs remains below the international benchmark of ≥ 85 % FPS. Enhanced formal training, wider availability of video laryngoscopes and SGAs, structured supervision protocols, and recurring simulation programmes are recommended to close this skills gap and improve patient safety.

Unduhan

Data unduhan belum tersedia.

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