# Language a potential challenge on 911 calls



## MMiz (Jul 28, 2008)

*Language a potential challenge on 911 calls*

A major problem facing area communities is how to respond to issues when emergency dispatchers cannot communicate with callers.

Morgantown Police Chief Billy Phelps said he recently ended up delivering a baby because the 911 communicators had a language barrier with a Hispanic caller.

*Read more!*

I can really see this being a problem in the small community I lived in last year.  They had an ever increasing Hispanic population, and had difficulty finding qualified bilingual for a variety of jobs.


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## Bosco578 (Jul 28, 2008)

MMiz said:


> *Language a potential challenge on 911 calls*
> 
> A major problem facing area communities is how to respond to issues when emergency dispatchers cannot communicate with callers.
> 
> ...




So True, happens here ALL the time.


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## firecoins (Jul 28, 2008)

guess its time we all learn to speak espanol.


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## NJN (Jul 28, 2008)

firecoins said:


> guess its time we all learn to speak espanol.



Whenever i encounter a Hispanic Pt. and their family (40-50% of my calls) it makes me want to kick myself for being a French and Italian student.


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## CFRBryan347768 (Jul 28, 2008)

firecoins said:


> guess its time we all learn to speak espanol.



Or they learn to speak english


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## MMiz (Jul 28, 2008)

CFRBryan347768 said:


> Or they learn to speak english


Of course we'd like all immigrants to speak English right after crossing the border, but that's not an option.

A couple of years ago I taught several students who literally just crossed the US/Mexican border, and landed up in my class.  They had many other changes and issues to deal with.  Ideally EMS should be able to communicate with every person, but of course that's not always a possibility.


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## Hastings (Jul 28, 2008)

At least we have ways to work around it once we're on scene. Both myself and my partner have field guides with us at all times that, among other things, have a long list of common/useful Spanish phrases. While neither of us speaks Spanish, we're able to point to the phrases in the book. Surprisingly, it works extremely well. Of course, the book doesn't include everything I'd like to know, but it knows enough to treat the patient as is necessary.


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## CFRBryan347768 (Jul 28, 2008)

MMiz said:


> Of course we'd like all immigrants to speak English right after crossing the border, but that's not an option.
> 
> A couple of years ago I taught several students who literally just crossed the US/Mexican border, and landed up in my class.  They had many other changes and issues to deal with.  Ideally EMS should be able to communicate with every person, but of course that's not always a possibility.



All they have to know is the basics. 

Name 
Age
Address
SS#
Telephone Number
What Hurts
When Did It Start 
Do You Know How It Could Have Started
Dr.'s Name 
Previous Med. Conditions/surgerys etc.
Allergys

Why do we have to take time out of our sched. to learn their language. Espically when some of us have to work 3 jobs and come home and raise a family.


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## mikeylikesit (Jul 28, 2008)

I don't mind those calls as long as the children are not hurt. mainly because the children can speak fluent engilsh almost always.


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## CFRBryan347768 (Jul 28, 2008)

mikeylikesit said:


> I don't mind those calls as long as the children are not hurt. mainly because the children can speak fluent engilsh almost always.



Yes this is true in my area also. Unless their crying then penlights go missing and anything else you can get to calm them down to get them to talk so you can understand them ha


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## Jon (Jul 28, 2008)

My County has a town which brags about being the "Mushroom capital of the world" - they hold a yearly Mushroom Festival with a Mushroom parade, a Queen... the whole 9 yards.

The growing portion of the county has a HUGE migrant population.

My county's 911 center uses Language Line (http://www.languageline.com/ - there are also other services out there). The 911 calltaker can patch in the Language Line folks and use them as an interpreter. Most of the local hospitals use Language Line or a similar service, and they have special phones with a 2nd handset so that they can have a 3-party call with a patient, medical provider, and the interpreter.

A lot of places have a list of in-house interpreters... but use Language Line when they can't get their own interpreter.



These services cost money... but given that the US has a lot of immigrants who don't speak english as a first language (not to mention fore gin tourists and guest workers).

Jon


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## MMiz (Jul 28, 2008)

Yeah, LanguageLine is good, but costs about $3 a minute.


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## firecoins (Jul 29, 2008)

CFRBryan347768 said:


> Or they learn to speak english



No. This isn't some national political issue.


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## CFRBryan347768 (Jul 29, 2008)

firecoins said:


> No. This isn't some national political issue.



No? So you are saying that we need to take the time to learn their language? You said it your self you have no life going through Paramedic school so is any one that works more then 1 job going to have time? NO! Thats absolutely ridiculous! It is not my job to understand them, or is it to take time out of my much needed work sched to take classes. And then you have the whole issuse of paying for it, theirs too much involved; they should learn the language or take a taxi.


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## MMiz (Jul 29, 2008)

CFRBryan347768 said:


> No? So you are saying that we need to take the time to learn their language? You said it your self you have no life going through Paramedic school so is any one that works more then 1 job going to have time? NO! Thats absolutely ridiculous! It is not my job to understand them, or is it to take time out of my much needed work sched to take classes. And then you have the whole issuse of paying for it, theirs too much involved; they should learn the language or take a taxi.


People have been using the "Learn the language or go home" argument for decades.  Of course you're not obligated to learn any language beyond your own, but it's becoming an important skill in today's world.

When it comes down to it, it's about serving your community.  If I worked and lived in a Hispanic community, it would be helpful to learn Spanish.  I grew up in a community with a large Russian population, and I learned the basics of Russian.  I think you'd find the same thing in many ethnic communities.

As a nation we've always hated the new guys.  Whether it be Hispanics, Asians, Italians, or the Irish, our history shows that no matter who they are, we don't like the new guy.  

Maybe you can expand your horizons a bit and think of the added benefit of learning a new language.  Pick up a book, or just google online for medical terms.  It would make you an even stronger medical provider in our diverse world.


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## Airwaygoddess (Jul 29, 2008)

Agreeded, what ever service you work for, and the population that you work in, it will benefit you for as a patient care advocate.


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## BrianJ (Jul 29, 2008)

CFRBryan347768 said:


> All they have to know is the basics.
> 
> Name
> Age
> ...



I'm curious to which part of the country you are in, I'm in Tucson, AZ where we have an enormous spanish speaking population.  Yes it would be nice if no language barriers existed, but if your patient can learn the above information how hard is if for you to learn the questions in spanish?  For almost all the questions you require them to learn the answers are going to be the same in spanish or english, Doctors names don't change from spanish to english.  Where it hurts can be (and often is) indicated by body language as opposed to vocal anyway.
Regardless of if you are fluent in spanish or not, spanish speakers will be very appreciative of your attempt to communicate with them in their native language.


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## mikie (Jul 29, 2008)

I've seen courses for Spanish for EMS/healthcare providers.  It definitely didn't help learning French in highschool (although I'm hoping one day I come across a French-only speaking patient!!).  I'll probably look into taking one, as it is inevitable that Spanish is becoming a more prominent language in the states (north, south east and west!).  

Though once I had a patient who didn't speak a word of English...just Mandarin Chinese.  I knew a few words in that dialect, so once I started speaking, the rest of the crew in the ambulance's jaws dropped.  Who knew!


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## ulrik (Aug 13, 2008)

*Foreign speaking patient*

and you don't know the language nor have a translator on call. what do you do ?


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## MMiz (Aug 13, 2008)

I think you'll find that most patients know a few words of English, even if your questions are simplified.  I've only used Spanish in the field once.  Many services use a telephone translation service where you put the patient on speakerphone and the translator will translate questions and responses.


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## KEVD18 (Aug 13, 2008)

MMiz said:


> I think you'll find that most patients know a few words of English, even if your questions are simplified.  I've only used Spanish in the field once.  Many services use a telephone translation service where you put the patient on speakerphone and the translator will translate questions and responses.



correct me if im wrong, but doesnt that service require a subscription? i've yet to work for a company that would write that check...

about all you can do is your best. treat what you can see. do a really focused assessment. all in all its much like a peds call. 

i worked for one service that was russian owned and subsequently had a significant russian clientele. it was standing orders that if there was a language issue, we were to call the owner and he would translate. whne i first started there, i was very reluctant to wake the guy who signs my checks at 2am. shortly before i left(after realizing how much i hated that chop shop) i called him every chance i got. bottom line there is if you treat your crews like poopie, it might just come back to bite you.


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## MMiz (Aug 13, 2008)

Kev,

Yes, the cost is about $2-$3 per minute.  I never used it in the field or know of anyone who has.


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## reaper (Aug 13, 2008)

Our service uses the translation service. We don't use it much, but if you need it, you call dispatch and they patch you through.


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## WuLabsWuTecH (Aug 13, 2008)

The service is called "language line". We don't have it in the field, but the hospital I'm at has it.  We've only used it once when a local translator was not avaliable and he was the only guy locally who knew the language.  You can use speaker phone or use a phone with two handsets (as we did to protect pt privacy)


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## Jon (Aug 13, 2008)

by the way - we talked about this regarding a news article a week or two ago... so I merged the threads.


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## Ridryder911 (Aug 14, 2008)

Good old common body and sign language usually works... as well as t-a-l-k-i-n-g  real s-l-o-w-& LOUD.. Don't know why most do that.. not like they are hard of hearing?


R/r 911


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## mycrofft (Aug 14, 2008)

*If you want to be the "tip of the spear", cut...to...the..chase.*

Despite some of the rhetoric I hear at work and am reading here, I fail to believe anyone here would abandon a pt just because they failed to speak English if it was apparent that the pt needed care NOW.

That said, you have to then take into account how to surmount this language divide. (And try that where I am...lots of folks speaking Spanish, Mexican dialects, SE Asian languages and dialects, Hindi, varieties of Chinese, Fiji, and broken English with cultural biases of many other flavors). Even with interpreter services, how do you ask the pt which language they speak before you dial the sevice? (Make and carry a 5X8 card with "Is this your language? " written in various local languages and have the pt point to the correct one). And remember to label each in english too! :blush:

My big problem is coworkers who speak English as a second language and can not be understood on the radio, take no or very screwed up phone messages  and send me on goose-chases becasue they can't dispatch due to CULTURAL, not language, issues.


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## BossyCow (Aug 14, 2008)

You can find a way to communicate. Facial expressions, yes/no questions? (I know yes and no in multiple languages) Instead of asking how long or when... pointing to a watch. We don't need to grasp the subtle nuances of a person's perception of the experience but merely find out.. "Does this hurt?" and "How bad?" 

If I'm looking at a grey, diaphoretic pt, grasping their chest and wincing, I'm not going to need to know that he had toast for breakfast an hour and a half ago in order to treat them.

Our hospital asks every employee to disclose which languages they know upon hire. There is a database at the hospital of who speaks what and how well. We've used that a time or two.


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## Tiberius (Aug 15, 2008)

When I worked in NYC I often had that issue. I did have some partners of Hispanic origin and that obviously eliminated the Spanish language barrier. I've encountered Russian and Chinese plenty of times, and used family members that had better command of the English language. When that wasn't available I'd call the hospital to let them know what the situation was and to have a translator either come to the phone or stand by at the hospital.

With the Chinese language, that was a bit more difficult. Until I started EMS, I did not know there were so many different dialects in the Chinese language. I'd find out what dialect they spoke and handle that as mentioned above.


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## ILemt (Aug 15, 2008)

They need to learn ENGLISH. I can go on with this topic forever, especially since  there are families in this area that have been in the US since their grandparents came over, but mom, dad and the kids only speak spanish even now that grandma is dead. Its insane. I asked someone about it once, their response was: 
(in horribly broken 'ingles')  " As long as job last, why need enlassh? "

Also, the local hispanic community enters the job market immediately after high school (if they finish that) and make no attempt to attend college. Thats another thing that burns my butt.
FYI,
I can "get by" in:
"Classic Spanish", "American Spanish" German,and Russian... but my point and anger above is still valid.


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## BossyCow (Aug 15, 2008)

ILemt said:


> They need to learn ENGLISH. ............................Also, the local hispanic community enters the job market immediately after high school (if they finish that) and make no attempt to attend college. Thats another thing that burns my butt.
> FYI,
> I can "get by" in:
> "Classic Spanish", "American Spanish" German,and Russian... but my point and anger above is still valid.



Wow, why waste precious life energy being angry about something over which you have no control? Very wise woman once said to me, "While you can't control what others do, you are in complete control over how you choose to respond to it?" I think it would be a better investment of your time to learn how to "accept the things you cannot change".


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## ILemt (Aug 19, 2008)

You have a valid point.
However, I'm from the school of thought that feels the Texan National Guard should install a minefield along the entire border and order a bunch of body bags.
 I also feel that in order to have a job in this country one should be able to speak English. (speaking your mother tongue at home is fine)

> end of rant <


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## reaper (Aug 19, 2008)

Yea, I think we should have accepted that British rule thing, rather then stand up to it. It would have saved a lot of wasted time!


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## KEVD18 (Aug 19, 2008)

if a person want to come into this country and be full assimilated into our world, they have to learn the language. i just dont care about immigrants who refuse to do so. 

if a department or service want to pay me to learn spanish(both the cost of the course and my hourly while im learning it) id be happy to do so. other than that, i have no intention to do so.

when my grandparents came here, they had to learn english. nobody was accomodating. its ridiculous the lengths we go to to accommodate ILLEGAL immigrants. how much money does the government spend in interpreters, multilingual forms, signs etc. im sick and tired of it.


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## karaya (Aug 19, 2008)

KEVD18 said:


> when my grandparents came here, they had to learn english. nobody was accomodating. its ridiculous the lengths we go to to accommodate ILLEGAL immigrants. how much money does the government spend in interpreters, multilingual forms, signs etc. im sick and tired of it.


 
Absolutely 110% bona-fide agree!!!


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## Aileana (Aug 20, 2008)

This happens _a lot_ in the area I rode out of. In that area, english-speakers are actually a minority. After a while, you either pick up bits and pieces of their language, or get really good at playing cherades . 

I don't mind as much if there's just a language barrier, but when they get angry at me, as if its my fault I don't speak ______, it gets frustrating. Had a patient yelling and screaming at me and all the hospital staff for that once. Finally tracked down a nurse that spoke his language to calm him down.


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## T1medic (Aug 26, 2008)

BossyCow said:


> You can find a way to communicate. Facial expressions, yes/no questions? (I know yes and no in multiple languages) Instead of asking how long or when... pointing to a watch. We don't need to grasp the subtle nuances of a person's perception of the experience but merely find out.. "Does this hurt?" and "How bad?"
> 
> If I'm looking at a grey, diaphoretic pt, grasping their chest and wincing, I'm not going to need to know that he had toast for breakfast an hour and a half ago in order to treat them.
> 
> Our hospital asks every employee to disclose which languages they know upon hire. There is a database at the hospital of who speaks what and how well. We've used that a time or two.



Perfactly put. I had a pt. not too long ago that spoke Bolivian(if I remember right). I don't remeber what we were called for though. I couldn't understand a word she spoke. I tried to listen to her carefully considered she was speaking very rapidly but did pick up o the fact she said _si' often, so as I would ask her a question about pain in certain spots I would speak slowly and loudly and shake my head yes while say sior nada'while shaking my head in a no fashion. Most questions can be based in a yes and no fashion when you have a language barrier.  With that being said I will not alter my pt. care just because of cultural differences but do believe that some English should be required for citizenship. Or at least effort put forth, most Americans when traveling to another country will use a pocket guide for the language. I don't see many Spanish speaking keeping a translation guide with them.  Think about it, is it easier for a group of people(spanish, russian, chinese,french, german or any nationality) to learn one language or ask us to learn 6 or 7 languages so we can all communicate effeciently. The same should apply to us moving to another country just so it is clear I am not one sided._


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