title: Parenteral analgesic and sedative use among ED patients in the United States: combined results from the National Hospital Ambulatory Medical Care Survey (NHAMCS) 1992-1997.
abstract: The objective of the study was to describe parenteral analgesic and sedative (PAS) use among patients treated in US emergency departments (EDs). Data representing 6 consecutive years (1992-1997) from the National Hospital Ambulatory Medical Care Survey (NHAMCS) were combined and analyzed. Patients were identified as having received PAS if they received fentanyl, ketamine, meperidine, methohexital, midazolam, morphine, nitrous oxide, or propofol. Patients were stratified according to age (pediatric <18 years), race, gender, insurance, type of hospital, urgency of visit, and ICD-9 diagnostic codes. Logistic regression was performed to determine independent associations and calculate odds ratios (OR) for receiving analgesia or sedation. A total of 43,725 pediatric and 114,207 adult ED encounters were analyzed and represented a weighted sample of 555.3 million ED visits. For patients with orthopedic fractures, African American children covered by Medicaid insurance were the least likely to receive PAS (OR 0.2, 95% confidence interval 0.1-0.6). These results suggest that variations may be occurring among ED patients receiving PAS.
authors.affiliation: Department of Pediatrics, Division of Emergency Medicine, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO 63110, USA. mark_hostetler@kids.wustl.edu
authors.forename: Mark A
authors.initials: MA
authors.lastname: Hostetler
authors.forename: Peggy
authors.initials: P
authors.lastname: Auinger
authors.forename: Peter G
authors.initials: PG
authors.lastname: Szilagyi
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000592:standards; D000700:Analgesics / Q000627:therapeutic use*; D002648:Child; D017723:Drug Utilization Review; D004636:Emergency Service, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007263:Infusions, Parenteral; D007348:Insurance, Health / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008485:Medical Audit; D010146:Pain / Q000188:drug therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D014947:Wounds and Injuries / Q000188:drug therapy
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives