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Thought Leader Session

Guidelines Session

Aging Adult Track

Additional Registration Fee

Research Snapshot Theater: Quality and Patient Safety, Adult and Pediatric III

Demographic Differences in Post-Rapid Sequence Intubation Analgesia

Sunday, March 22, 2026

12:15 PM - 1:15 PM Central Time

Location: Connections Central - RST 10

Savannah Creed, MS (she/her/hers)

Georgetown University School of Medicine

Disclosure(s): No relevant financial relationship(s) to disclose.
MG

Munish Goyal, MD

Physician
MedStar Washington Hospital Center

Disclosure information not submitted.
Jacqueline Caputo, MS (she/her/hers)

District of Columbia

Disclosure(s): No relevant financial relationship(s) to disclose.
AC

Amelia Cogan, MPH

Medical Student
Georgetown University School of Medicine

Disclosure information not submitted.
AA

Anthony Amaru, BS

Medical Student
Georgetown University School of Medicine

Disclosure information not submitted.
VK

Victoria Kim, MS

Medical Student
Georgetown University School of Medicine

Disclosure information not submitted.
TQ

Tania Quintero, BS

Medical Student
Georgetown University School of Medicine

Disclosure information not submitted.
KA

Katarina AuBuchon, PhD

Post-Doctoral Fellow
Lombardi Comprehensive Cancer Center, Georgetown University

Disclosure information not submitted.
PM

Patricia McCabe, RN, MSN, ACNP

Nursing Director
MedStar Washington Hospital Center

Disclosure information not submitted.
CV

Chloe Verwiel, BA

Physician
Georgetown University School of Medicine

Disclosure information not submitted.

Introduction: Rapid-sequence intubation (RSI) is a high-intensity, painful procedure. Patients should receive analgesics post-RSI to manage discomfort and aid sedation. However, no studies to date explore demographic analgesic differences post-RSI that could indicate inequitable care. We hypothesized that, consistent with past research, Black (vs. White), female (vs. male), and older (vs. younger) patients would be less likely to receive any opioid and receive lower cumulative analgesic doses post-RSI.

Methods: We conducted a retrospective study of Black and White identified adults intubated in 2019 across seven academic and community emergency departments, excluding patients with suspected neurological injury. Research assistants unaware of study hypotheses extracted basic demographics and analgesia administration two hours post-RSI from the health record. Opioid doses were converted into Morphine Milligram Equivalent (MME). As only 29.4% of patients had any MME post-RSI, a zero-inflated poisson model assessed relationships between sex, racial group, age, covariates (13 comorbidities, pre-RSI hypotension, weight, neuromuscular blocker, induction dose, and hospital), and a patient’s likelihood of receiving any MME (zero-model) and MME amount (count model).

Results: There were 1,211 patients included, with 65.81% Black; 46.05% Female; Age M = 59.83. Higher age was associated with significantly lower likelihood of receiving an opioid (OR=0.81, p=0.021) and lower MME doses when receiving an opioid (RR=0.87, p<.001). Black (vs. White) patients had significantly higher odds of receiving an opioid (OR=1.66 , p=.010), but lower MME doses (RR=0.71, p< 0.001). Sex did not significantly influence receiving opioids, but females received lower MME doses than males (RR=0.90, p=.018), taking weight into account. Interactions of age with both sex and racial group indicated that sex and racial differences in MME doses narrowed as age increased.

Conclusions: Black, female, and older patients received lower opioid doses post-RSI. Yet, Black patients were more likely to receive any opioid, and sex and racial group differences narrowed as age increased. Our data identify a need to investigate equity in opioid administration post-RSI, and the ways these differences manifest.