Beyond "Red Man Syndrome": A Case for American Indian Health Equity.

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Sitting in the lecture hall, the first-year medical student, an American Indian first-generation college graduate, was shocked and dismayed when learning about antimicrobial agents and their side effects as the professor described “red man syndrome” (RMS). The student was relieved when other students in the course discussed the racial insensitivity of this term and cited recent articles calling for the removal of this language. However, this feeling of isolation and damage was already inflicted. Unfortunately, this experience is not rare. Minority medical trainees experience microaggressions and bias daily.1 As a medical community, we must do better. Konold et al present a strong example of using rapid-cycle quality improvement methodology to purge the antiquated, racially insensitive term RMS from the medical record.2 They describe how the documentation of 274 pediatric patients who had been diagnosed with RMS within their hospital was successfully removed from charts.2 In addition, the success of this intervention is supported by the reduction of the use of this language 3 months after the intervention, with only 29 of 65 charts with vancomycin allergies listed citing RMS. Importantly, the rate of use revealed a statistically significant difference preintervention and postintervention ( P < .001).2 This approach is used to substitute more medically descriptive and correct terminology, “vancomycin flushing reaction” or “vancomycin infusion reaction”, as recently recommended by the Infectious Diseases Society of America and Pediatric Infectious Diseases Society.3–5 The quality improvement project by Konold et al serves as a simple and disseminatable action that other hospitals can emulate.2 They describe how others can use electronic medical records to address the racial injustice of terminology with further education to continue to make positive changes toward equality in the …