Demystifying Emergency Medicine Interpretation (Part 2: Settings)

Emergency Medicine Interpreting Settings

InterpreMed’s next comprehensive medical interpreting study guide is all about emergency medicine! In our last post, we discussed special considerations in the U.S. healthcare system when it comes to emergency medicine, including reliance upon emergency rooms/departments as primary care due to barriers to healthcare, as well as the prominent role social workers may play in emergency medicine. This time, we’re going to be going over different settings in which medical interpreters may interpret for this exciting specialty.

Emergency Medical Services Call (911)

When asked to share their experiences interpreting in emergency medicine, many over-the-phone/telephonic interpreters in the group U.S. Medical Interpreters shared their experiences interpreting for calls with 911 dispatchers. 911 is the universal emergency telephone number for both the United States and Canada. When someone calls 911, their call is answered at a Public Safety Answering Point (PSAP) and may be transferred to a secondary PSAP. It is during this process that an interpreter may be brought on the line to interpret for spoken-language callers with limited English proficiency. Dependent upon the caller’s emergency, different emergency personnel may be sent to the caller’s location.

How do D/deaf & Hard of Hearing People Contact 911?

Remember: not only LEPs utilize interpreters! There are a few options for D/deaf and hard of hearing people experiencing an emergency to contact 911:

  • Dial 911
    The first option is simply to dial 911 and leave the phone on. When the dispatcher asks the person to state their emergency and no one responds, they will dispatch emergency services to the location. This is the least ideal solution, as the location may be determined by cell phone towers miles away or an out-of-date address registered to the number.
  • Text-to-911
    Text-to-911 enables callers to send a text message via a mobile device to PSAPs. However, the issue with this solution is that there is no rule mandating call centers accept text messages, despite the FCC encouraging PSAPs to implement text-to-911 capabilities.
  • VRS
    VRS stands for video relay service. Utilizing this service, a D/deaf, hard of hearing, or speech-impaired caller, with the help of a communications assistant (CA) can communicate with others who have standard telephonic capabilities. This way, even if the PSAP doesn’t have text-to-911 or TTY capabilities, the caller can still communicate with the dispatcher for their emergency.

Tips for Interpreting Spoken-Language 911 Calls

When asked about their experiences interpreting for emergency medicine, many interpreters shared a lot of useful information and tips for interpreting for 911 dispatchers. It’s important to note that many calls that are placed don’t necessarily qualify as emergencies, but even so, it’s incredibly important to stay on alert and always give your full attention. You never know when poor call quality or an incoherent/hysterical caller will throw you off.

911 dispatchers are trained to cut straight to the chase, as time can often be of the essence in emergency situations. This requires the interpreter and the dispatcher to work together as a team to get crucial information from the caller. Interpreters repeatedly emphasized the importance of taking the dispatcher’s lead, matching their tone and speed. It was also pointed out that dispatchers may even cut you off when trying to get information from a rambling LEP. Remember not to take this personally!

A road sign in Reykjavík, Iceland. Would you be able to tell someone an address on this street from memory? Image credit: I Love Typography

One interpreter detailed a situation in which the LEP caller did not know their own address, which some people may find strange, but it’s important to note that addresses can be a common point of confusion for some LEPs. I’ve experienced this firsthand at hospital registration interpreting for routine procedures, in which the LEP had their address saved on their phone or written on a piece of paper because it was too difficult to remember. Imagine trying to remember a street address in a country that speaks a language that you don’t understand!

Emergency Room/Department

While typically only telephonic interpreters interpret for 911 calls, all kinds of interpreters have experience interpreting in the emergency room (ER) and/or emergency department (ED). Keep in mind that in addition to hospital ERs, there are also standalone EDs! Some hospital systems employ staff interpreters, and depending upon the size of the facility or hospital system, they may have dedicated interpreters for this department or a language services department that provides on-site interpretation services in shifts or on an as-needed basis. During the COVID-19 pandemic we’ve even seen the emergence of systems in which on-site staff interpreters interpret remotely via phone, tablet, or computer either from the hospital campus or their own homes, especially in high-risk patient environments like the ER or ICU.

Some hospitals choose to use a combination of on-site staff interpreters and remote phone or video interpreters, the majority of whom are independent contractors. Other hospitals choose instead to supplement their on-site staff interpretation services with on-site freelance interpreters, or utilize them in addition to remote interpretation. In sum: whether staff or freelance/contractor, on-site or remote, interpreters of all types may be utilized in an emergency room or department! This is why it’s important for all interpreters to familiarize themselves with and practice interpreting in emergency medicine.

Emergency at Outpatient Facility

An often overlooked setting in which interpreters may be utilized for interpretation in an emergency medical situation is outpatient facilities. There is always a possibility a patient for whom you are interpreting at an outpatient clinic or other facility can experience a medical emergency that may necessitate the interpreter continuing to interpret until Emergency Medical Services (EMS) arrive. Just like at the ER or ED, this can happen to any interpreter, whether in person, remote, as a staff interpreter, or as an independent contractor. Again, this underscores the importance of being prepared to interpret in emergency medicine situations.

What About Ambulances?

A paramedic from Northwell Health utilizing a video interpreter via iPad. Image credit: Northwell Health – Lee Weissman (Retrieved from Newsday)

This begs the question: how do LEPs access language assistance services while being transported via ambulance or another emergency transport vehicle? There’s very little publicly-available information on the utilization of language services in ambulances, which may be due to the fact that many localities in the United States have a combination of both public (taxpayer-funded) and private ambulance services. Due to space constraints, it’s likely that if language services are utilized in transport (as they should be!) interpretation is likely to occur via video or phone.

Part 3: What’s It Like Interpreting in Emergency Medicine?

Now that we’ve learned about emergency medicine in the United States, as well as different emergency medicine settings in which interpreters may end up interpreting, our next article in this series will focus on real advice and experience from real interpreters who have interpreted in the field of emergency medicine. What are their tricks and tips for interpreting in emergency medicine settings? What are some of the difficulties interpreters face in this challenging specialty? These questions (and more!) will be answered in the next installation of our series.

Emergency Medicine Study Guide

If you simply can’t wait for the next article, be sure to check out our emergency medicine study guide to practice your emergency medicine interpreting skills. Not only do we have consecutive interpreting practice scripts, as well as simultaneous interpreting practice audios with different speeds, but we have produced a wide range of medical interpreting vocabulary practice activities, including our longest medical specialty interpreting glossary yet. If you aren’t already a member, be sure to join InterpreMed’s learning community for medical interpretation professionals!

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