Race and Ethnicity and Prehospital Use of Opioid or Ketamine Analgesia in Acute Traumatic Injury
Authors' conclusion
In this nationwide study of patients treated by EMS for acute traumatic injuries, patients from racial or ethnic minority groups were less likely to have a pain score recorded, with Native American and Alaskan Natives the least likely to have a pain score recorded. Among patients with a high pain score, patients from racial and ethnic minority groups were also significantly less likely to receive opioid or ketamine analgesia treatment, with Black patients having the lowest adjusted odds of receiving these treatments.
Study context
- Population
- US patients aged 14 to 99 years with painful acute traumatic injuries (incl burns) treated and transported by an ALS unit after 911 EMS activation, 2019–2021
- Participants
- 4,781,396 EMS activations
- Exposure
- Race and ethnicity categories vs White patients
- Whiten = 2,764,499reference
- American Indian or Alaskan Nativen = 31,266
- Asiann = 59,713
- Blackn = 742,931
- Hispanic or Latinon = 411,934
- Native Hawaiian or other Pacific Islandern = 10,747
- Multiple racesn = 16,161
- Outcome
- Recording of a pain score; administration of a nonoral opioid or ketamine (when a high pain score is recorded)
Methodological detailsnationwide
- Nationwide
Main finding
As reported in the abstract
Each group vs whiteAdjusted odds ratio (95% CI)
American Indian or Alaskan Nativepain score recorded; lowest aOR
0.74(0.71–0.76)
Blackopioid or ketamine analgesia among patients with high pain score (7–10 of 10)
0.53(0.52–0.54)
Observational data: associations, not effects.
Original publication
Race and Ethnicity and Prehospital Use of Opioid or Ketamine Analgesia in Acute Traumatic Injury. JAMA Netw Open. Published 2 October 2023. doi:10.
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