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"I Don't Speak English Well." Do Language Barriers Affect Automated External Defibrillator Use? A Randomized

Myriam Santos-Folgar¹, Roberto Barcala-Furelos, María Fernández-Méndez

¹From the REMOSS Research Group, Facultade de Ciencias da Educación e do Deporte (M.S.-F., R.B.-F., M.F.-M., M.O.-A., J.E.-B.) Universidade de Vigo, Pontevedra, Spain; School of Nursing of Pontevedra, (M.S.-F., M.F.-M., M.O.-A.), Universidade de Vigo, Pontevedra, Spain; Department of Midwifery, Primary Care Center of Lérez (M.S.-F.), Sergas, Pontevedra, Spain; CIDEGA, Universidade de Vigo, Facultade de Ciencias da Educación e do Deporte (R.B.-F.), Pontevedra, España; CLINURSID Research Group (R.B.-F., S.M.-I.), Public Health, Nursing and Medicine Department, Universidade de Santiago de Compostela, Psychiatry Santiago de Compostela, Radiology, Spain; Simulation, Life Support and Intensive Care Research Unit of Santiago de Compostela (SICRUS) (R.B.-F., S.M.-I.), Simulation and Intensive Care Research Unit of Santiago (SICRUS), Health Research Institute of Santiago de Compostela (IDIS), Departamento de Psiquiatría, Radiología, Salud Pública, Enfermería y Medicina, Universidade de Santiago de Compostela. Simulation, Life Support and Intensive Care Research Unit of Santiago de Compostela, Spain; GRAFAIS Research Group (J.W.-P., S.A.-G.), Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona, Barcelona, Spain; Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin (RICORS) (S.M.-I.), Carlos III Institute of Health, RD21/0012/0025, Madrid, Spain, Spanish network in maternal, neonatal, child and developmental health research (RICORS-SAMID, Instituto de Salud Carlos III, Madrid, Spain; Department of Primary Care (J.E.-B.), Primary Care Center of Foz, Sergas, Foz, Lugo, Spain; and Faculty of Health (S.A.-G.), Universidad Camilo José Cela, Madrid, Spain.

Simulation in Healthcare : Journal of the Society for Simulation in Healthcare

|December 24, 2025

Summary

Using automated external defibrillators (AEDs) in a non-native language is possible, but may reduce safety and delay crucial post-shock CPR. Native language instructions ensure better performance for out-of-hospital cardiac arrest survival.

Keywords:

Cardiac arrest automated external defibrillators (AED)defibrillation language barriers

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Area of Science:

Emergency Medicine
Public Health
Cardiology

Background:

Early defibrillation is critical for survival after out-of-hospital cardiac arrest.
Public access automated external defibrillators (AEDs) improve survival and neurological outcomes.
Language barriers can hinder AED effectiveness in diverse populations.

Purpose of the Study:

To compare automated external defibrillator (AED) operation skills and timing between native and foreign language instructions.
To evaluate the impact of language on critical safety actions during simulated cardiac arrest scenarios.

Main Methods:

A randomized pilot study involved 50 Spanish-speaking university students with no prior AED training.
Participants were assigned to receive AED instructions in either Spanish (native) or English (foreign).
Performance was assessed during a simulated cardiac arrest scenario using a mannequin and AED trainer, with actions video-recorded.

Main Results:

Both groups had high AED operation completion rates.
The native language group demonstrated significantly better performance in critical safety actions, including ensuring no one touched the victim before shock and initiating CPR post-shock.
While shock delivery time after pad placement was faster in the foreign language group, critical safety steps were compromised.

Conclusions:

Automated external defibrillator (AED) use is feasible with non-native language instructions.
Foreign language prompts may compromise safety and delay or omit essential post-shock CPR.
Native language AED instructions are recommended to optimize performance and patient outcomes.