Language barriers

[whit72]

I was just wondering, with the increase of non English speaking population soaring in the United States. How do you handle the different problems that present themselves.

This has been a growing problem for me over the past few years, with what seems like the majority of my pts being non English speaking. I worry at times that I can not completely understand or decipher the needs of the pt.

Not so much in the critical category, as with those you can usually decipher through assessment or the context clues. Its more the non-life threatening issues that arise that at times I cant seem to get a handle on due to the fact that I can not converse with these pts, in other words finding and otherwise healthy individual seated at home, with no visual clues to injury or illness.

I find these the most difficult situations. When I am trying to communicate with these people I am weary that I am not able to get the gist of their complaint and worry at times that when I drop my note to the ER that I may be leading hospital staff in the wrong direction. ( I have attached an article for you to see what I mean) http://content.nejm.org/cgi/content/full/355/3/229

I have tried the english to"______ " guides. (Fill in any of the twenty different languages you may come in contact with on a daily basis.) It seems as if the different dialects of spoken languages the words or phrases often have different meanings.

We don't have adequate translation services although there seems to be a new phone system coming on line soon in which you can request an interpreter if you are able to identify the language.

Just wondering how you handle these issues.

[paramedicmike]

If you know what language your patient speaks, follow these instructions:

1. Dial 911 from a landline.

2. Identify yourself and your unit to the dispatcher.

3. Ask for a patch through to the language line.

4. When the interpreter gets on the line, identify yourself as an EMS provider in need of translation for a patient you're trying to treat.

It requires a bit of passing the phone back and forth but I have had some fair success it. Languages I've had to access included Russian, Chinese, Vietnamese among others.

At the very least it can get you set up with information prior to transport.

I have tried it with a cell phone but did not have much success. Part of that was I think it was a poor connection. Part of that, too, I think came from the fact that when I dialed 911 on my cell phone I got a call center in another state.

If you can get a decent cellular connection you may be able to take it with you in the ambulance. That'll depend on your local coverage area.

Hope this helps you.

-be safe.

[Guest CHP medic]

I usually just yell really loud and slow in English.

[bassnmedic]

We utilize the language line speaker boxes in our units so that we don't have to call dispatch. Language line is a very beneficial tool to have, as Mike pointed out it can provide several different language interpreters.

Take care and stay safe.

Todd

[nbsp]

I have tried it with a cell phone but did not have much success. Part of that was I think it was a poor connection. Part of that, too, I think came from the fact that when I dialed 911 on my cell phone I got a call center in another state.

I suggest looking up your local 7-digit number for 911 and putting it on your cell phone contact list. This might take a while even with google, but I was able to find mine with the keywords "9-1-1 7-digit number [city, state]". You might have to play around with the keywords a bit. Take out the dashes, use 10 instead of 7, etc.

If anyone happens to be in my county, (Santa Clara, CA), you can find your emergency number on page 11 of here. Unfortunately I wasn't able to find a website that gave the local number for everywhere, so you'll probably have to look it up yourself.

[akflightmedic]

I usually just yell really loud and slow in English.

Hahaha...You are soo right.

I try to teach this to all my students and partners. People just don't get it. If someone does not understand English, it is ALWAYS better to yell loudly and exaggerate every syllable. This has never failed me yet.

Even hearing impaired people (not the ones with hearing aids, but the ones who use ASL 100 percent of the time to communicate), I have found by talking really loud and again overexagerrating each syllable makes it much eaier for them to communicate.

Such morons, geesh its so simple yet you all are trying to make it difficult.

[Timmy]

So far I’ve had 2 non English speaking French and German patients, both at motocross. With the French guy his Aussie mate could speak French so it was all good, although it did take a while for this guy to get out to us. So you could kinda imagine me on the side of the track trying to explaining in sign language just to lay there an relax, the flag marshal was giving me funny looks lol. With the German guy his mum could speak enough English to communicate, although she was blind…

[whit72]

Thanks for all the replies, I will look for the language line.

[Dustdevil]

Hahaha...You are soo right.

I try to teach this to all my students and partners. People just don't get it. If someone does not understand English, it is ALWAYS better to yell loudly and exaggerate every syllable. This has never failed me yet.

You guys are forgetting one key factor in the success of this technique. While yelling loudly and slowly in English, it is important that you affect a faux foreign accent, mocking the patient's native language. This is particularly effective in Spanish, even if Spanish is not the patient's language.

My honest answer to this is I just don't care. If they speak English, they get good care. If they speak Spanish, they get decent care. If they speak anything else, they get the same care as an unconscious patient -- ABC's and a ride to the hospital (whether they want to go or not) where it then becomes their problem, not mine.

[Guest CHP medic]

Your right again Dust. I can pretty much hold my own in spanish, which are about a third to half of our patients. But we also have a large south-east asian comunity, and I'm not even going to try to understand or speak Hmong or Cambotian. Usually you can find someone at the scene who can somewhat interpret for you, but for most calls I'm not going to waste time calling that number. It is a good resource though, as we've used it frequently for law enforcement purposes.