title: Triage in the Tower of Babel: interpreter services for children in the prehospital setting.
abstract: Minority pediatric populations have higher rates of emergency medical services use than the general pediatric population, and prior studies have documented that limited-English proficiency patients are more likely to undergo invasive procedures, require more resources, and be admitted once they arrive in the emergency department. Furthermore, limited-English proficiency patients may be particularly vulnerable because of immigration or political concerns. In this case report, we describe an infant with breath-holding spells for whom a language barrier in the prehospital setting resulted in an escalation of care to the highest level of trauma team activation. This infant underwent unnecessary, costly, and harmful interventions because of a lack of interpreter services. In a discussion of the legal, ethical, and medical implications of this case, we conclude that further investigation into prehospital strategies for overcoming language barriers is required to provide optimal prehospital care for pediatric patients.
authors.affiliation: From the *Division of Pediatric Emergency Medicine, Department of Emergency Medicine, University of New Mexico School of Medicine, Albuquerque, NM; †Department of Pediatrics, Bioethics Division, University of Washington School of Medicine, Seattle, WA; and ‡Treuman Katz Center for Pediatric Bioethics, Seattle Children's Hospital, Seattle, WA.
authors.forename: Ramsey C
authors.initials: RC
authors.lastname: Tate
authors.forename: Maureen C
authors.initials: MC
authors.lastname: Kelley
mesh_terms: D000058:Accidental Falls; D001049:Apnea / Q000175:diagnosis* / Q000209:etiology; D062485:Breath Holding; D003144:Communication Barriers; D006259:Craniocerebral Trauma / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004632:Emergency Medical Services / Q000191:economics / Q000458:organization & administration*; D058015:Health Communication; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007223:Infant; D007802:Language; D008297:Male; D014057:Tomography, X-Ray Computed / Q000191:economics; D014175:Translating; D014218:Triage; D019564:Unnecessary Procedures / Q000191:economics
chemical_list: D006993:Hypnotics and Sedatives