No habla espanol? No hay problema, at least not entirely. Language and the ability to communicate is something often taken for granted. It’s not until that fundamental part of human interaction, and a pillar of patient assessment is challenged or completely removed do we realize and respect its importance.
We have all had to manage patients that were unconscious or had an altered mental status due to drugs or alcohol, seizures, trauma, etc. Theses patients have limited, or are incapable of verbal communication. So we work around it the best we can, and rely on our physical assessment and findings to help guide the treatment plan.
But what if you have a patient that is completely awake and alert, is in obvious distress, and can not communicate because of a language barrier? Well, like we have all done, you probably look around at the other personnel on scene, patients family and friends, or sometimes even bystanders to find a translator. While this practice is an option, its not always practical or reliable. And in the case of bystander assistance, no longer is the patients information confidential.
A 2007 American Community Survey conducted by the United States Census Bureau, showed that Spanish is the primary language spoken at home by over 34 million people aged five or older, making the United States the world’s fifth-largest Spanish-speaking community, outnumbered only by Mexico, Spain, Colombia, and Argentina. Thus making Spanish one of, if not the most common non-English language encountered by EMS providers in this country.
If only there was a better way…
Lately I have been using, and introducing others to a little book called, EMSpanol. And in my opinion, it is the most user friendly, and comprehensive English to Spanish (and Spanish to English) field translating system, that is not digitally based. I believe one of the big advantages to EMSpanole is that it was created by working EMS providers, and not a language teaching company. It is straightforward, and intuitive.
Jeff Dean, the co-creator, and working Paramedic and Firefighter says “Like most of the prehospital providers I know, I basically speak no Spanish at all, but I work and volunteer in a region with a large and growing Hispanic population. I’ve struggled with other commercial products, finding them either too general, too disorganized, or created by authors with no EMS experience, so I created my own list of phrases and looked around for someone to translate them for me. More than seven years went by before I finally met FF/EMT-B Miguel Castañares, who embraced the project and took it to a whole new and exciting level.”
The book comes in two sizes: A 30 page ambulance edition which is approximately 9″x11″ and can be easily stored in the patient care area, and a smaller 37 page pocket version that fits comfortably in uniform pockets, and first-in bags. The two books are identical in content and format. It covers everything form the initial patient contact, all the way to MCIs and even refusals.
Each chief complaint is laid out in a logical sequence, so that the provider can start at the top of the page, and simply read through the call as if there was no language barrier to begin with. The questions are also written so the patient need only answer, yes or no. There is even a basic anatomical chart on the back.
In my experience with other field guides, I found them to be disorganized, and hard to understand. But honestly the only problem I have found when using EMSpanol, is that having a Spanish speaking partner is an easy excuse not to use it. At this stage I can understand more then I can speak, But it has increased my emergency Spanish vocabulary.
I would love to see this little book be used in practice as common as the Broselow Tape. I would also recommend it as a gift to any new EMT, Paramedic, or Fire Academy graduate.
But wait, there’s more.
It’s obvious after talking with, Jeff that he is very passionate about EMS and providing the best care that he can give his patients. He also has brought up some very thought provoking issues in regards to scope of practice in a language barrier scenario. Most will just try to ignore it, but these are discussions we as a community need to be having.
Jeff was featured as a guest on the EMS Educast podcast, where he talks about the book, and his thoughts about scope of practice in a language barrier scenario. I encourage you to listen the episode —-> HERE
For more information check out http://www.emergencylanguage.com/ and follow on Twitter and Facebook
