| Popis: |
Although evidence suggests that racial and ethnic minority (REM) patients receive inadequate pain management in the acute care setting, it remains unclear if these disparities also occur during the prehospital period. The aim of this study is to assess the impact of race and ethnicity on prehospital analgesic utilization by emergency medical services (EMS) in trauma patients.Retrospective chart review of adult trauma patients aged 18-89 years old transported by EMS to our ACS verified Level 1 trauma center from 2014-2020. Patients who identified as Black, Asian, Native American, or Other for race and/or Hispanic or Latino or Unknown for ethnicity were considered REM. Patients who identified as White, non-Hispanic were considered White. Groups were compared in univariate and multivariate analysis. The primary outcome was prehospital analgesic administration.2,476 patients were transported by EMS (47% White and 53% REM). White patients were older (46 vs. 38, p0.001) and had higher rates of blunt trauma (76% vs. 60%, p0.001). There were no differences in injury severity score (ISS) (21 vs. 20, p=0.22). Although REM patients reported higher subjective pain rating (7.2 vs. 6.6, p=0.002), they were less likely to get prehospital pain medication (24% vs. 35%, p0.001) and that difference remained significant after controlling for baseline characteristics, transport method, pain rating, prehospital hypotension, and payor status (Adjusted OR [95% CI] 0.67 [0.47 - 0.96], p=0.03).Patients from racial and ethnic minority groups were less likely to receive prehospital pain medication after traumatic injury than White patients. Forms of conscious and unconscious bias contributing to this inequity need to be identified and addressed. |
