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Translator use not associated with longer time to pain medication in initial evaluation of low-severity geriatric trauma - 21/09/22

Doi : 10.1016/j.ajem.2022.06.057 
Jing Jing Gong, MD a, Chun-Cheng Chen, MD b, Johnathan Lebaron, DO a, Michael A. Chary, MD PhD a, c,
a NewYork-Presbyterian/Queens Hospital, Department of Emergency Medicine, Flushing, NY, United States of America 
b NewYork-Presbyterian/Queens Hospital, Department of Surgery, Flushing, NY, United States of America 
c NewYork-Presbyterian Hospital, Weill Cornell Medical College, Department of Emergency Medicine, New York, United States of America 

Corresponding author.

Abstract

Objectives

Determine whether geriatric victims of blunt trauma who preferred to communicate in a language other than English waited longer for pain medication or received more imaging studies than English-speaking patients with the same age and injuries. Secondary outcomes were the type of medication administered and number of imaging studies.

Methods

We conducted a retrospective analysis of all trauma activations to a single academic urban medical center from January 2019 to October 2019. We included all hemodynamically stable patients older than 65, with head or torso trauma after a low energy injury, and on at least one medication that was an anti-coagulant, anti-platelet, or chemotherapeutic.

Results

We identified 1,153 unique patients (17, 379 radiologic studies) performed from January 2019 to October 2019, with a median of 5 (4–6) radiologic studies per patient. We excluded 419 patients for whom the language used was not reported (n = 7), no imaging was not reported (n = 16), or no medication was recorded as given (n = 409), leaving 734 patients for further analysis. Of those 734 patients, 460 preferred to communicate in English, 84 in Mandarin Chinese, 64 in Spanish, 37 in Cantonese Chinese, and 35 in Korean, and 29 in Russian. Across all languages patient age and Injury Severity Score (ISS) were comparable. Those who preferred to communicate in Spanish, Russian, or Korean were more likely to be female than those who preferred English, Mandarin, or Cantonese, but this tendency was not statistically significant (χ2-test; p = 0.051, 0.15 after Bonferroni correction). We did not find a statistically significant association between preferred language and time to medication, fraction of opioids used as first-line pain medication, or number of imaging studies performed. Across all patients, the most common medications administered were acetaminophen (524/734, 71%), any opioid (111/734, 15%), followed by local infiltration or nerve block with lidocaine (49/734, 6.7%).

Conclusions

A retrospective analysis of patients with low-risk blunt trauma found no relationship between preferred language, time to pain medication, use of opioids or number of imaging studies.

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Keywords : English Proficiency, Trauma care, Emergency Medicine, Geriatrics, English Language, Emergency Department, Geriatric Emergency Medicine, Electronic Medical Record


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Vol 60

P. 62-64 - octobre 2022 Retour au numéro
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