• Am J Emerg Med · Sep 2014

    Observational Study

    Prospective, 10-year evaluation of the impact of Hispanic ethnicity on pain management practices in the ED.

    • Philip Craven, Orhan Cinar, David Fosnocht, Jessica Carey, Adrienne Carey, LeGrand Rogers, Kajsa Vlasic, and Troy Madsen.
    • University of Utah School of Medicine, Salt Lake City, UT. Electronic address: philcraven14@hotmail.com.
    • Am J Emerg Med. 2014 Sep 1; 32 (9): 105510591055-9.

    IntroductionHispanic ethnicity has been reported as an independent risk factor for oligoanalgesia in the emergency department (ED).ObjectivesThe objectives are to compare pain management practices in White and Hispanic patients in the ED to determine whether treatment differences exist.MethodsProspective analysis of a convenience sample of patients presenting to an urban, academic, tertiary-care ED over the 10-year period from 2000 to 2010. We compared patients with pain-related complaints of any nature, who self-identified their race as White or Hispanic, and evaluated initial morphine administration/dosing, arrival/disposition pain scores, and overall ED satisfaction scores (0-10 scale).ResultsFifteen thousand sixty patients were enrolled. Eighty-one point 2 percent (n, 12 232) of the patients were White and 11.2% (n, 1680), Hispanic. White and Hispanic patients reported similar pain at presentation (6.7 vs 7.3, P < .001) and discharge/admission (4.6 vs 4.8, P = .14). Hispanic patients were not less likely to receive an analgesic during the ED visit (odds ratio, 1.06; confidence interval, 0.96-1.17; P = .62), nor less likely to receive an opioid analgesic (odds ratio, 0.97; confidence interval, 0.88-1.08; P = .70). Hispanic patients, on average, received similar initial doses of morphine (4.1 vs 4.3 mg, P = .29) and had similar wait times from arrival to initial dose of morphine (82 vs 86 minutes). Overall ED satisfaction scores were the same (8.7 vs 8.7, P = .65).ConclusionWhite and Hispanic patients were similar in rates of initial morphine administration for pain-related complaints. These findings contrast with previous studies reporting lower rates of initial analgesia administration among Hispanic patients in the ED.Copyright © 2014 Elsevier Inc. All rights reserved.

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