Implications of systemic racism in emergency medical services: On prehospital bias and complicity

Ventura, Christian; Denton, Edward E; Asack, Benjamin R

doi:10.1016/j.eclinm.2022.101525

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…As the win ratio can be interpreted as a relative risk, the impact of Black ethnic appearance and women’s gender on prioritization is clear: 0.66 for women vs. men and 0.75 for Black appearances vs. others. All those constatations could also be linked, or come in addition with, systemic racism [19]. This must change, and more ethnic minority practitioners should be recruited in the ED [20].…”

Section: Discussionmentioning

confidence: 99%

Do emergency medicine health care workers rate triage level of chest pain differently based upon appearance in simulated patients?

Coisy,

Olivier,

Ageron

et al. 2023

European Journal of Emergency Medicine

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Background and importance There seems to be evidence of gender and ethnic bias in the early management of acute coronary syndrome. However, whether these differences are related to less severe severity assessment or to less intensive management despite the same severity assessment has not yet been established. Objective To show whether viewing an image with characters of different gender appearance or ethnic background changes the prioritization decision in the emergency triage area. Methods The responders were offered a standardized clinical case in an emergency triage area. The associated image was randomized among eight standardized images of people presenting with chest pain and differing in gender and ethnic appearance (White, Black, North African and southeast Asian appearance). Outcome measures and analysis Each person was asked to respond to a single clinical case, in which the priority level [from 1 (requiring immediate treatment) to 5 (able to wait up to 2 h)] was assessed visually. Priority classes 1 and 2 for vital emergencies and classes 3–5 for nonvital emergencies were grouped together for analysis. Results Among the 1563 respondents [mean age, 36 ± 10 years; 867 (55%) women], 777 (50%) were emergency physicians, 180 (11%) emergency medicine residents and 606 (39%) nurses. The priority levels for all responses were 1–5 : 180 (11%), 686 (44%), 539 (34%), 131 (9%) and 27 (2%). There was a higher reported priority in male compared to female [62% vs. 49%, difference 13% (95% confidence interval; CI 8–18%)]. Compared to White people, there was a lower reported priority for Black simulated patients [47% vs. 58%, difference −11% (95% CI −18% to −4%)] but not people of southeast Asian [55% vs. 58%, difference −3% (95% CI −10–5%)] and North African [61% vs. 58%, difference 3% (95% CI −4–10%)] appearance. Conclusion In this study, the visualization of simulated patients with different characteristics modified the prioritization decision. Compared to White patients, Black patients were less likely to receive emergency treatment. The same was true for women compared with men.

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Section: Discussionmentioning

confidence: 99%

Do emergency medicine health care workers rate triage level of chest pain differently based upon appearance in simulated patients?

Coisy,

Olivier,

Ageron

et al. 2023

European Journal of Emergency Medicine

View full text Add to dashboard Cite

show abstract

“…21,22 The impact of implicit biases on pain management has been previously demonstrated among physicians and nurses 21,22 ; to date, there is a dearth of literature examining implicit biases among EMS practitioners. 23,24 Lack of diversity is also associated with poorer interpersonal communication with patients, especially when the practitioner and patient are of different races, 25 which has important implications for clinical outcomes. 26 Health disparities in acute pain management in the emergency department…”

Section: Health Disparities In Acute Pain Management In the Prehospit...mentioning

confidence: 99%

Health disparities in regional anesthesia and analgesia for the management of acute pain in trauma patients

Patton

Burton

Milam

et al. 2022

International Anesthesiology Clinics

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Racial, Ethnic, and Socioeconomic Disparities in Out-of-Hospital Pain Management for Patients With Long Bone Fractures

Crowe¹,

Kennel

Fernández³

et al. 2023

Annals of Emergency Medicine

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Implications of systemic racism in emergency medical services: On prehospital bias and complicity

Cited by 3 publications

References 7 publications

Do emergency medicine health care workers rate triage level of chest pain differently based upon appearance in simulated patients?

Do emergency medicine health care workers rate triage level of chest pain differently based upon appearance in simulated patients?

Health disparities in regional anesthesia and analgesia for the management of acute pain in trauma patients

Racial, Ethnic, and Socioeconomic Disparities in Out-of-Hospital Pain Management for Patients With Long Bone Fractures

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