Journal of Immigrant and Minority Health

, Volume 17, Issue 4, pp 1049–1054 | Cite as

Delivering 9-1-1 CPR Instructions to Limited English Proficient Callers: A Simulation Experiment

  • Hendrika Meischke
  • Brooke Ike
  • Ian Painter
  • Devora Chavez
  • Mei Po Yip
  • Steven M. Bradley
  • Shin-Ping Tu
Original Paper


Having 911 telecommunicators deliver CPR instructions increases cardiac arrest survival, but limited English proficiency (LEP) decreases the likelihood callers will perform CPR and increases time to first compression. The objective of our study was to assess which 9-1-1 CPR delivery modes could decrease time to first compression and improve CPR quality for LEP callers. 139 LEP Spanish and Chinese speakers were randomized into three arms: receiving CPR instructions from a 9-1-1 telecommunicator (1) with telephone interpretation, (2) using alternative, simple ways to rephrase, or (3) who strictly adhered to protocol language. Time interval from call onset to first compression, and CPR quality were the main outcomes. The CPR quality was poor across study arms. Connecting to interpreter services added almost 2 min to the time. CPR training in LEP communities, and regular CPR training for phone interpreters may be necessary to improve LEP bystander CPR quality.


CPR Limited English proficiency 9-1-1 Health communication Immigrants 



This paper was supported by Grant R18 TP000316-01 from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention. We would like to thank our community partners: the Chinese Information and Service Center, Casa Latina, and New Futures for their assistance with recruitment and interpretation. We would also like to thank Scott Stangenes for his meticulous work on the study as a research assistant.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Hendrika Meischke
    • 1
  • Brooke Ike
    • 1
  • Ian Painter
    • 1
  • Devora Chavez
    • 1
  • Mei Po Yip
    • 2
  • Steven M. Bradley
    • 3
  • Shin-Ping Tu
    • 2
  1. 1.Department of Health Services, Northwest Center for Public Health PracticeUniversity of WashingtonSeattleUSA
  2. 2.Division of General Internal Medicine, School of MedicineUniversity of WashingtonSeattleUSA
  3. 3.Department of MedicineUniversity of WashingtonSeattleUSA

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