ABSTRACTS
A Comparative Analysis of Prehospital Pain Management in Sexual and Gender MinoritiesAuthor: Luis G. Reyes | Paramedic | Sampson County EMS Associate Authors: Houston, Sara E., MHS, NRP, NCEE | Munna, Jr., Jerome C., BS, Paramedic | Kaplan, Ginny R., PhD, MHS, Paramedic, FAEMS | Hubble, Michael, W., PhD, MBAA, NRP
Introduction While disparities in the prehospital use of analgesia have been well-studied, there is limited evidence exploring whether similar disparities exist in sexual and gender minorities (SGM). Objective To determine the relationship between analgesia administration by emergency medical services (EMS) clinicians and SGM status. Methods A retrospective analysis of the 2023 ESO Data Collaborative was performed. Inclusion criteria consisted of patients with any documented initial pain score and gender. Because Midazolam was included as a potential analgesic, patients with primary or secondary impressions of seizures were excluded. Descriptive statistics were utilized to define the sample, while a chi-square analysis was used to create a 3x3 contingency table to analyze the proportions of SGMs who received no analgesia, received NSAIDs (Acetaminophen, Aspirin, Ibuprofen, Ketorolac), or received controlled substances (Fentanyl, Hydromorphone, Ketamine, Meperidine, Morphine, or Nitrous Oxide), which was then stratified by the initial reported pain score (0–10). Results Of the 8,092,312 patients with a documented pain score, 3812 identified as SGMs. Only 685,207 (8.5%) received any type of analgesia, of which 232 identified as SGMs. Females comprised 47.5% of the population, with males making up 52.5%. SGMs were almost universally undertreated at every pain score irrespective of the receipt of NSAIDs or controlled substances. When looking at treatment with NSAIDs on a pro rata basis, 2.0% of SGMs were treated compared to 4.0% of males and 4.6% of females, a 54% and 73% relative increase, respectively. With the receipt of controlled substances, the pro rata rates of treatment for SGMs, males, and females were 3.5%, 4.3%, and 4.1%, respectively. Compared to SGMs, males received controlled substances 23% more often, while that relative increase was 17% for females. Each level of recorded pain score was significant between groups (all p<0.01) Conclusion In this retrospective analysis, EMS clinicians were less likely to administer analgesics to SGM patients. Additional research is needed to ascertain additional confounders that affect analgesia administration in this patient population.
|
