Useful Information

Overcoming Communication Barriers in Emergency Situations

Some Basic Tools

Image about Overcoming Communication Barriers in Emergency SituationsPicture communication boards are used internationally
August 17, 2009

 Emergencies occur daily around the world. Both natural and human-caused disasters can create an emergency. Events like the swine flu pandemic or a terrorist attack, as well as floods, fires, earthquakes and other natural disasters require that the people most directly affected be able to communicate effectively and efficiently with those who are trying to help them, i.e., first responders and first receivers in emergency rooms, hospitals, shelters and so on.  

In emergency situations, communication breakdowns between potential victims and first responders/medical personnel can have dire consequences including unnecessary pain, misdiagnoses, drug treatment errors, unnecessarily long hospital stays and even death. These communication breakdowns occur often and for a number of reasons. For example, a person may have difficulty speaking or understanding a first responder because of a preexisting condition (disabilities affecting hearing, seeing, speaking or understanding). In addition, language barriers often exist when first responders and receivers have difficulty talking to people who speak a different language. Many areas have people who speak many different languages . Also, first responders/receivers may come from other countries to help. In addition, communication may be difficult when people are under intense stress, which is inevitable during an emergency.

People in emergency situations regularly report instances in which communication barriers result in feelings of anxiety, fear, frustration, unrecognized pain, and overall loss of control.   

First responders face an especially critical need for communication. They need to reach people in trouble, often under emergency conditions. They must accurately assess each person's need in order to administer the proper care in the field. Without access to interpreters, these heroes must rely on simple, low-tech products to enable them to give the best possible care, reducing both morbidity and mortality rates.

Language boards are among the most helpful tools for communicating in the field. If a person does not have a clear command of English, is too ill or traumatized to speak clearly, or has a chronic speech problem, language boards enable patients and first responders to communicate through words and pictures. Products such as the Kwik Point Medical Translator have boards aimed specifically at emergency situations. These boards include pain scales as well as picture sets to express nausea, dizziness, and other common symptoms. Although language boards are simple devices, they quickly provide paramedics and EMTs with the communication skills necessary to assess a patient's condition. In addition, materials originally developed for health care settings (such as Vidatak boards, see below) can also prove useful in emergency settings.

As the number of persons with limited-English proficiency rises in the United States, first responders have found it increasingly necessary to speak other languages, especially Spanish. Several organizations have risen to this challenge by developing language programs geared specifically toward first responder needs. SpanishOnPatrol and Spanish 4 Emergencies both offer online Spanish classes that focus on the phrases and vocabulary first responders are most likely to encounter while on duty. Spanish 4 Emergencies also offers a variety of products that serve as an easy reference while in the field.

Listed below are some of the more common communication tools for first responders/receivers to facilitate communication while in the field.

 Kwikpoint Medical Translators
http://www.kwikpoint.com
Kwikpoint Medical Translators are laminated booklets that facilitate communication between hospital staff and non-English speaking patients.  The cards include pictures for basic medical-related topics and assistance phrases that patients can point at to express their needs.  Translators are available in Spanish and French as well as for disaster assistance.

Emergencia! Emergency Translation Manual by Lisa Maitland de Hernandez
http://www.emergencystuff.com/0766836266.html
EMERGENCIA! Emergency Translation Manual is a language reference for English speaking medical caregivers who need to communicate effectively with Spanish speakers in emergency situations. Translations of a wide array of medical emergencies include phonetic pronunciations of words and phrases and relevant questions that require only "yes" or "no" answers. Diagrams of the human body labeled in Spanish and pages of commonly used words and phrases further facilitate communication and ultimately quicken response time.

Spanish 4 Emergencies
http://www.spanish4emergencies.com
Spanish for Emergencies is dedicated to bridging the communication gap between emergency workers and Spanish-speaking residents. Their products and tools help insure the safety of first responders and those they serve. The company offers Spanish language training geared specifically toward law enforcement, fire/EMS personnel, and dispatchers. A variety of products such as sexual assault cards, anatomy sheets, quick reference sheets, and CPR cards provide quick translations on relevant topics.

Spanish on Patrol
http://www.SpanishOnPatrol.com
SpanishOnPatrol offers complete Spanish courses in public safety to help officials gain the language skills they need to respond in a safe and effective way. Online classes are offered for law enforcement, fire/EMS, 911 dispatch, park rangers, and corrections officials.

Critical Communicators/Pocket Communicators
http://www.interactivetherapy.com
These communication boards assist staff in interacting with patients who cannot speak or who have limited English proficiency through the use of pictures. Content includes pain scale, pictures for immediate needs, and comfort among others. The Critical Communicator is available in over 20 languages.

I Speak Card
http://www.dss.cahwnet.gov/civilrights/PG584.htm
The Department of Justice's Civil Rights Division publishes an I Speak Card containing 38 languages to help first responder personnel identify the language their patients speak. The card can be downloaded for free here.

Disaster Preparedness Tips for Emergency Management Personnel:  Communication Access for People with Limited Speech
http://aac-rerc.psu.edu/index-120.php.html
The AAC-RERC has prepared materials for first responders/receivers to use with people who have complex communication needs. The site offers a PDF of a free Emergency Communication Aid for downloading and tips for emergency personnel who may not be adequately prepared to communicate with people who are unable to rely on their natural speech during an emergency. There is also a webcast by Pamela Kennedy (AAC-RERC Writers Brigade). It describes 7 steps for emergency preparation that are critical for all individuals with difficulty using speech

Vidatak Communication Boards
http://www.vidatak.com
The EZ Board enables health care providers to communicate with patients with impaired communication. The board is intended for use with patients who cannot speak and with non-English patients. Boards are 17 x 11, two-sided, dry-erase boards with new research-based content and are available in 17 languages.

Communication Picture Board
http://www.eadassociates.com/products.html#cpb

The Communication Picture Board was designed initially to help bridge the communication gap between emergency first responders and people who are deaf. The picture board has proven also to effectively enhance the communications needs between first responders and non-English speaking populations, children, people with developmental disabilities, as well as those impacted by a traumatic event. It has also been used extensively in hospital settings The Communication Boards contain pictures with a word describing the picture underneath in both English and Spanish. On the back of the board, a number of other languages are listed, so that (literate) non-English speakers can identify their language, if other than English or Spanish.

 Tips for First Responders (4th edition)
http://cdd.unm.edu/dhpd/images/Fourth%20Edition.pdf
Tips for First Responders is a 14-page, color-coded, laminated 4.5 x 5.5-inch field guide, incorporating "tip sheets" that provide information that first responders can use during emergencies as well as routine encounters. They are not meant to be comprehensive, but contain specific information that can be read quickly either before or while responding to an incident, and can be downloaded free or purchased in laminated field guide form. Tips are included for persons with a wide range of disabilities, as well as Seniors, People with Service Animals, People with Mobility Challenges, People with Mental Illness, Blind or Visually Impaired People, Deaf or Hard of Hearing People, People with Autism, People with Multiple Chemical Sensitivities, People with Cognitive Disabilities,  and Childbearing Women and Newborns.

Health Care Communications Board
http://www.greenhousepub.com/hecacobo.html
Designed originally for use in hospitals, rehab units, acute care, emergency rooms, assisted living facilities, nursing homes, clinics, hospice care and in the home, the Health Care Communications Board can provide an inexpensive alternative for communication in emergency situations (200 boards for $39.00). It includes (1) pain scale for determining where and scale for determining where and how bad one hurts (2)  68-clear, 4-color pictures depicting wants, needs, ailments, comforts, questions, emotions, etc., (3) easy to understand instructions for patient response alternatives, (4). Alphabet  for spelling out words, and (5) numbers for numerical information.