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Clinical paper| Volume 169, P105-112, December 2021

“I’m sorry, my English not very good”: Tracking differences between Language-Barrier and Non-Language-Barrier emergency ambulance calls for Out-of-Hospital Cardiac Arrest

  • Nirukshi Perera
    Correspondence
    Corresponding author.
    Affiliations
    Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Curtin University, Bentley, WA 6102, Australia
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  • Tanya Birnie
    Affiliations
    Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Curtin University, Bentley, WA 6102, Australia
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  • Hanh Ngo
    Affiliations
    Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Curtin University, Bentley, WA 6102, Australia
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  • Stephen Ball
    Affiliations
    Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Curtin University, Bentley, WA 6102, Australia

    St John WA, Belmont, WA 6104, Australia
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  • Austin Whiteside
    Affiliations
    Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Curtin University, Bentley, WA 6102, Australia

    St John WA, Belmont, WA 6104, Australia
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  • Janet Bray
    Affiliations
    Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Curtin University, Bentley, WA 6102, Australia

    Department of Epidemiology and Preventive Medicine, Monash University, Victoria 3004, Australia
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  • Paul Bailey
    Affiliations
    Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Curtin University, Bentley, WA 6102, Australia

    St John WA, Belmont, WA 6104, Australia
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  • Judith Finn
    Affiliations
    Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Curtin University, Bentley, WA 6102, Australia

    St John WA, Belmont, WA 6104, Australia

    Department of Epidemiology and Preventive Medicine, Monash University, Victoria 3004, Australia

    Emergency Medicine, The University of Western Australia, Crawley, WA 6009, Australia
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      Abstract

      Background

      One-fifth of Australia’s population do not speak English at home. International studies have found emergency calls with language barriers (LB) result in longer delays to out-of-hospital cardiac arrest (OHCA) recognition, and lower rates of bystander cardiopulmonary resuscitation (CPR) and survival. This study compared LB and non-LB OHCA call time intervals in an Australian emergency medical service (EMS).

      Methods

      The retrospective cohort study measured time intervals from call commencement for primary outcomes: (1) address acquisition; (2) OHCA recognition; (3) CPR initiation; (4) telecommunicator CPR (t-CPR) compressions, in all identified LB calls and a 2:1 random sample of non-LB EMS calls from January to June 2019. Results for time intervals #1, 2, and 4 were benchmarked against the American Heart Association’s (AHA) t-CPR minimal acceptable time standards. Patient survival outcomes were compared.

      Results

      We identified 50 (14%) LB calls from a cohort of 353 calls. LB calls took longer than non-LB calls (n=100) for: address acquisition (median 29 vs 14 secs, p<0.001), OHCA recognition (103 vs 85 secs, p=0.02), and CPR initiation (206 vs 164 secs, p=0.01), but not for t-CPR compressions (292 vs 248 secs, p=0.12). Rates of OHCA recognition and 30-day-survival did not differ but smaller proportions of LB calls met the AHA standards.

      Conclusion

      Time delays found in LB calls point to phases of the call which need further qualitative investigation to understand how to improve communication. Overall, training call-takers for LB calls may assist caller understanding and cooperation during OHCAs.

      Keywords

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