Racial and Ethnic Differences in ED Analgesia Among Injured Children Transported Via EMS

Area of Science:

• Pediatric Emergency Medicine
• Health Services Research
• Health Disparities

Background:

• Pain management in emergency settings is often suboptimal.
• Racial and ethnic disparities in pediatric pain management are not well understood.
• Emergency Medical Services (EMS) transport to pediatric Emergency Departments (EDs) is a critical juncture for analgesia administration.

Purpose of the Study:

• To investigate racial and ethnic disparities in the timing of pain management for injured children transported by EMS to pediatric EDs.
• To analyze differences in the administration of analgesia based on race and ethnicity.

Main Methods:

• Secondary analysis of a multicenter prospective observational study.
• Inclusion of 480 injured children transported by EMS to 10 pediatric EDs.
• Analysis of analgesia timing stratified by race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, Other/Multiracial) and medication type (opioids, non-opioids).

Main Results:

• Hispanic children experienced a longer median time to the first dose of any ED analgesia (55 minutes) compared to other racial/ethnic groups.
• No significant differences were found in the time to the first dose of opioid analgesia by race or ethnicity.
• Factors such as long bone fractures and prior EMS opioid administration were associated with receiving ED analgesia.

Conclusions:

• Significant race and ethnicity differences exist in the time to receive any analgesia for injured children in the ED after EMS transport.
• No delays in ED opioid analgesia administration were observed based on race or ethnicity.
• Further research is necessary to identify and address the root causes of these observed disparities in pain management timing.