Prehospital and Disaster Medicine

Original Research

Serving Limited English Proficient Callers: A Survey of 9-1-1 Police Telecommunicators

Lauren N. Carrolla1 c1, Rebecca E. Calhouna1, Cleo C. Subidoa2, Ian S. Paintera1 and Hendrika W. Meischkea1

a1 Department of Health Services, University of Washington, Seattle, Washington USA

a2 Seattle-King County Public Health, Emergency Medical Services Division, Seattle, Washington USA


Introduction The emergency telephone number 9-1-1 serves as a lifeline to the public during emergencies, and first responders rely on information gathered by 9-1-1 telecommunicators who speak with callers. Timely, accurate information from the telecommunicators is essential for providing appropriate care on scene. Language barriers can hamper these efforts and result in less efficient information exchange. Although 9-1-1 telecommunicators may access over-the-phone interpreter (OPI) services to facilitate communication, managing three-way communication during an emergency is challenging.

Problem There is little published on the relationship between limited English proficient (LEP) callers and 9-1-1 police telecommunicators, and the role of OPI services during these calls. Further, little is known about effective strategies to manage such calls.

Methods In King County, Washington, 9-1-1 police telecommunicators were surveyed about their experiences handling LEP calls and managing three-way communication with OPI services. The survey contained 13 multiple-choice and three open-response questions addressing communication strategies, challenges with LEP callers, and three-way communication with OPI services. Goodman-Kruskal Gamma and chi-square tests were conducted with OPI use as the dependent variable. Additional analyses were conducted using stress levels as the dependent variable.

Results Of 123 respondents, 69 (56.5%) 9-1-1 telecommunicators reported utilizing OPI services at least 75% of the time when receiving a call from an LEP caller. Further, 35 (28.7%) of these telecommunicators reported calls with LEP individuals as more stressful than calls with fluent English speakers. Dispatcher stress level during LEP calls compared with stress during calls with fluent English speakers was positively associated with use of OPI services (P < .01). Further, stress level was also positively associated with telecommunicator difficulties in assessing the situation with respect to officer safety (P < .01). Sixty-three (58.3%) of the telecommunicators described difficulties assessing the situation to determine the appropriate response as the biggest challenge with LEP callers. Additionally, 62 (53%) identified knowing their location in English as information LEP callers need to know prior to calling 9-1-1.

Conclusion These results highlight intervention opportunities for both 9-1-1 telecommunicators and LEP communities. Together, interventions such as working with LEP communities to educate them on best communication practices during 9-1-1 calls, and with 9-1-1 telecommunicators to help them manage three-way communication and reduce stress associated with concern for officer safety may improve emergency communication during 9-1-1 calls.

LN Carroll, RE Calhoun, CC Subido, IS Painter, HW Meischke. Serving limited English proficient callers: a survey of 9-1-1 police telecommunicators. Prehosp Disaster Med. 2013;28(3):1-6 .

(Received August 22 2012)

(Revised November 21 2012)

(Accepted December 02 2012)

(Online publication March 28 2013)


  • emergency communication;
  • English proficiency;
  • language proficiency;
  • occupational stress;
  • police officer


  • LEP:limited English proficient;
  • LLLP:limited local language proficient;
  • OPI:over-the-phone interpreter


c1 Correspondence: Lauren N. Carroll, MS Department of Health Services Northwest Center for Public Health Practice University of Washington 1107 NE 45th St., Suite 400 Seattle, WA 98105 USA E-mail


  Conflicts of interest and funding: The authors declare no conflicts of interest. This study was supported by Grant #5P01TP000297 from the Centers for Disease Control and Prevention.