Differences in Prehospital Assessment by Language Barrier Among Blunt Trauma Patients: A National Emergency Medical...

Language barriers may impede Emergency Medical Services (EMS) evaluation and treatment of trauma patients, potentially leading to misdiagnosis and poorer outcomes. We examined whether patient-provider language barriers were associated with differences in prehospital evaluation and management of blunt trauma patients.

A retrospective review of EMS activations was conducted using the ImageTrend Collaborate dataset. Blunt trauma patients evaluated by EMS nationwide from 2022 to 2023 were included. Data were categorized into language barrier (LB) and no language barrier (NLB) groups, with LB defined as cases where EMS providers documented an LB with the patient. Univariate and bivariate analyses were conducted using Stata, version 19.0.

Among 1,220,982 blunt trauma patients, 24,857 (2%) had a documented LB. LB patients were more likely to be male (53.5% versus 47.4%, P < 0.05), younger (44 versus 58 mean age, P < 0.05), and Hispanic (58.9% versus 7.6%). LB patients were more frequently injured in motor vehicle collisions (25.6% versus 17.1%, P < 0.05), whereas NLB patients were most frequently injured in falls (29.5% versus 19.9%, P < 0.05). A slightly greater proportion of LB patients presented with low Glasgow Coma Scale scores (3-8) compared with NLB patients (5.2% versus 4.2%, P < 0.05). LB patients were more likely to be treated and transported to the hospital (80.3% versus 75.1%, P < 0.05) and less likely to have pain scores documented (60.6% versus 63.6%, P < 0.05). The mean on-scene time was similar between groups (17.0 versus 17.4 min).

Patient-provider LBs in blunt trauma patients were associated with differences in demographic characteristics, injury mechanisms, and prehospital assessment patterns. Further research is needed to better characterize associations between LBs and trauma care and to improve standardized reporting practices.