Racial disparities in emergency care for seizures in the United States

02 September 2021
Volume 11 · Issue 3



Racial disparities exist regarding emergency medical services, and advanced life support (ALS) is superior to basic life support (BLS) for patients experiencing a seizure.


This study aims to identify if there are racial disparities regarding access to ALS care for patients having a seizure.


This study analysed 624 011 seizure cases regarding the provision of BLS rather than ALS care per racial group. Chi-square testing was used to check statistical significance and effect size was measured using relative risk.


On average, non-white patients experiencing a seizure had a 21% higher relative risk of receiving BLS care than white patients. The highest disparity concerned American Indian patients, who had a 66% higher relative risk of receiving BLS care than white patients.


Overall, non-white patients are less likely to receive ALS when experiencing a seizure than white patients, potentially leading to worse prehospital outcomes from less access to time-critical medications.

Emergency medical services (EMS) personnel form the foundation of care for patients in the prehospital setting. However, the level of care they can provide is not uniform. There are significant differences in education and training among EMS personnel and the US National Highway Traffic Safety Administration recognises four distinct levels of training for EMS personnel: emergency medical responder (EMR), emergency medical technician (EMT), advanced emergency medical technician (AEMT), and paramedic (EMS Data Cube, 2019; National Association of State EMS Officials (NEMSIS), 2019).

Traditionally, EMS units comprise two to three EMS personnel in a ground ambulance, which is classified as either advanced life support (ALS) or basic life support (BLS) depending on the level of training of the EMS personnel on board (Ryynänen et al, 2010). EMRs and EMTs provide BLS care, paramedics provide ALS care and AEMTs provide BLS or ALS care depending on local guidelines (NEMSIS, 2019).

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