Ethnicity as a risk factor for inadequate emergency department analgesia

Article Abstract:

Ethnicity may influence whether a patient in the emergency room receives pain relief. Of 139 emergency room patients with isolated long-bone fractures, 108 were non-Hispanic white and 31 were Hispanic. Non-Hispanic whites were significantly more likely to speak English, to have health insurance and to have fractures from non-occupational injuries. Altogether 94 patients received pain medication in the emergency room. However, 55% of the Hispanic patients did not receive pain medication compared with only 26% of the non-Hispanic white patients. Of the following patient characteristics - ethnicity, sex, language, insurance status and severity of fracture - ethnicity was the strongest predictor of whether a patient received pain medication.

Social aspects, Demographic aspects, Hispanic Americans, Discrimination in medical care, Medical care discrimination, Ethnicity

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Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma

Article Abstract:

A clinical decision rule to identify which patients who had blunt trauma need an X-ray of the neck appears to be accurate. The rule states that patients probably do not have a spinal fracture if they are alert, not intoxicated, and have no neck pain or tenderness, no neurologic symptoms, and no other injury that would keep them from feeling neck pain. In a study of 34,069 patients who had a neck X-ray after blunt trauma, this rule identified all but 8 of the 818 patients who had a spinal injury. The rule could have prevented 4,309 X-rays.

Blunt trauma

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Who is at low risk after head or neck trauma?

Article Abstract:

Two studies published in 2000 tried to determine which patients would not need an X-ray of the neck or CT scan of the neck. They used clinical decision rules, which are lists of signs and symptoms doctors can use to identify patients with a low or high risk of a specific condition. One study used a clinical decision rule on 34,069 patients who suffered blunt trauma to identify those who did not need a neck X-ray. The other used a clinical decision rule on 909 patients with head injury to identify those who did not need a CT scan.

Editorial, Head injuries

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