Impact of language barrier during emergency call on out of hospital cardiac arrest treatment and outcomes.
Resuscitation · 2025-06-11 · Observational study
Abstract
BACKGROUND: In out-of-hospital cardiac arrest (OHCA), a language barrier between a 9-1-1 caller and telecommunicator can challenge communication and OHCA recognition. However, little is known about downstream effects on care. We assessed how a language barrier in the 9-1-1 call influences the chain of survival and clinical outcomes after OHCA. METHODS: We conducted a cohort investigation of adult OHCA in King County, Washington between 2014-2023. Audio recordings were used to determine language barrier. We applied chi-square, Mann-Whitney-U test, and logistic regression to compare links in the chain of survival and clinical outcomes according to language barrier. RESULTS: Of 6146 eligible OHCA, 204 (3%) involved a language barrier. A language barrier was associated with delays in OHCA recognition (2.0 vs 1.0 min), time to assisted bystander CPR (2.2 vs 1.1 min), lower rates of bystander CPR (75% vs 89%) and early AED application (7% vs 13%) (p < 0.001, for all). EMS and hospital care did not differ between those with versus without a language barrier including field intubation (95% vs 96%), epinephrine administration (88% vs 88%), post-OHCA coronary angiogram (27% vs 33%) and targeted temperature management (54% vs 52%) (p > 0.19 for all). Likewise, outcomes did not differ according to language barrier status including rates of hospital admission (46% vs 41%) and survival to discharge (18% vs 17%) (p > 0.1 for all). CONCLUSION: Language barrier challenged early CPR and defibrillation but was not associated with differential EMS or hospital care, highlighting the potential for systems to effectively care for OHCA regardless of 9-1-1 language barrier.
Tags
Bystanders & volunteers · Communication & handover · Dispatchers & call takers · Equity & disparities