1st Minute with First Responders: Dealing with Language Barriers

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Recently, we began speaking with First Responders about situations they’ve experienced dealing with non-English speakers.  This Fire/EMS leader works for a mid-sized department (250 personnel) that serves population of 250,000. 

The Story

It was Sunday, July 5 around 6 a.m. (the last hour of the shift), and everyone was tired and not focused. A call came in for an unknown EMS emergency and the caller did not speak English and there was no translator. We headed out to the west side of town, and when we arrived there were three elderly Koreans, one man and two women. The man kept gesturing to his chest indicating chest pain so we started treatment for a heart attack. I went around the apartment complex trying to find a neighbor that spoke both English and Korean that could possibly translate. I finally found another elderly women who spoke a little English and we figured out that the man was just constipated and there was no real medical emergency. Many 911 calls are like this – no real emergency.  But, when there is a real emergency, language barriers are definitely an ongoing problem.

Did you consider using Language Line during this call?

No, we have Language Line but I’ve only used it a few times. It’s slow and you have to input access codes so it’s just not very convenient. You can lose valuable treatment time trying to connect with a translator.

Why is the first 60 seconds so important when paramedics show up on a scene?

It’s when you make your initial diagnosis and see which direction the care is going to take. We say it’s either going to be a “load and go” or “stay and treat”. For example, if someone’s arm is immobile, you need to figure out if it’s the result of a previous stroke or if it’s just happened in order to determine if they need to be transported to a stroke center or not.

What challenges do First Responders Face?

First responders face the challenge of having to make quick life/death decisions.  It’s a stressful job and we do our best to help those we come across.

Do all EMS personnel carry a smartphone or tablet during emergency response situations?

Everyone has some sort of electronic patient care report via “tough book” or something similar. I’d say its about 50/50 that they have their own personal phone. I never carry my own phone on calls and would not want to hand it over to a patient. We use the rugged laptops in our region – they’re about ⅔ the size of a normal laptop, are durable, and have a touchscreen.

What are the ideal attributes of a mobile app?

We use a computerized version of paper patient care reports (PCRs). It would require a lot of training and time for someone who is not familiar with them to completely understand. Ideally, any mobile app we use needs to be intuitive. It needs to be something that anyone, but especially patients in distress, can easily use.

How satisfied are you with the current method?

Language Line is definitely a “no”.  It’s not even a real option. As for the actual hardware, the rugged laptops are not ideal either, as they are slow and lose connection all the time.  We may be on the backside of this tech curve though, with cities like Dallas moving on to Windows tablets. We need something that is *extremely* durable and works as good as a high-quality laptop or smartphone.

How often is the language barrier an issue?

It really depends on location, especially in the DFW Metroplex where any given town is highly diverse.  In each region, you’ll see very little language diversity and areas where language barriers are constantly going to be an issue.

How often would you use an app like 1st Minute?

I think of it as more of an insurance policy. You might not have language barrier issues often, but you’re going to need the right resource for it when it happens.  This is especially important when you have no network access to call Language Line.  Since 1st Minute doesn’t require that connection, it’s a good match to meet the needs of us First Responders.

Blog by Anna Gentsch

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