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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.

Original publication




Journal article


Pediatr Emerg Care

Publication Date





1280 - 1282


Accidental Falls, Apnea, Breath Holding, Communication Barriers, Craniocerebral Trauma, Diagnosis, Differential, Diagnostic Errors, Emergency Medical Services, Health Communication, Humans, Hypnotics and Sedatives, Infant, Language, Male, Tomography, X-Ray Computed, Translating, Triage, Unnecessary Procedures