Abstract
Influence of Patient Race on Administration of Analgesia by Student Paramedics
Prehospital Emergency Care, Vol.22(1), p.111
NAEMSP Scientific Assembly, 2018 (San Diego, United States, 08-Jan-2018–13-Jan-2018)
2018
Abstract
Background: Disparities in healthcare are associated with factors that include social status, age and race or ethnicity, with evidence showing African American individuals receive fewer procedures and poorer-quality medical care than white individuals. Disparities in the management of pain have been shown to be associated with race. However, there is limited data regarding the influence of race on analgesia provided by paramedics. As such, this study aims to investigate associations between patient race and student paramedic management of pain, using a null hypothesis of no difference. Methods: This retrospective cohort study used a contiguous dataset of all student paramedic records entered in the FISDAP Skill Tracker database between January 1, 2014 to December 31, 2015. Cases were extracted if aged 16 to 100 years, the patient was alert and the primary or secondary impression was trauma (abdominal, chest, extremity, neck-back, multi) or burns. Head injury was excluded as this is a contraindication to analgesia in some settings. The primary outcome of interest was the interaction between patient race and student paramedic administration of any analgesia for cases meeting inclusion criteria. Secondary outcomes of interest were associations between age and gender and analgesia administration. The adjusted logged odds of patients receiving any analgesic was tested with binomial logistic regression using a stepped modelling approach. Results: Atotal of 59,962 cases were available for analysis; median age was 50 years (IQR 39 years), 50.2% were female (n=30,077). The most common cause of trauma was fall, representing 50% (n = 26,053) of cases. 14.1% of patients received any analgesia (n = 8,425). Caucasian patients have significantly higher logged odds of receiving analgesia than non-Caucasian patients (p < 0.001). When analgesic administration is adjusted for age category and gender, African Americans have the lowest logged odds of receiving any analgesia when compared to Caucasian patients (OR 0.65, p < 0.001). Conclusions: The results indicate inequality in the provision of analgesia by student paramedics based on patient race. This suggests a need for education that addresses cognitive and affective biases that can affect clinical judgements, and EMS audit of cases to identify disparities in care based on race.
Details
- Title
- Influence of Patient Race on Administration of Analgesia by Student Paramedics
- Authors
- Bill Lord (Author) - University of the Sunshine Coast - Faculty of Science, Health, Education and EngineeringSahaj Khalsa (Author)
- Publication details
- Prehospital Emergency Care, Vol.22(1), p.111
- Conference details
- NAEMSP Scientific Assembly, 2018 (San Diego, United States, 08-Jan-2018–13-Jan-2018)
- Publisher
- Taylor & Francis Inc.
- Date published
- 2018
- DOI
- 10.1080/10903127.2017.1377791
- ISSN
- 1090-3127
- Organisation Unit
- University of the Sunshine Coast, Queensland; School of Nursing, Midwifery and Paramedicine - Legacy
- Language
- English
- Record Identifier
- 99450689302621
- Output Type
- Abstract
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- Emergency Medicine
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Source: InCites