Intubations Misunderstood

This month I have been spending my time working hard in the Intensive Care Unit–where intubations are an unfortunate necessity. I invariably started thinking about who gets intubated. We look at many factors to assess a patient’s ability to breathe, such as respiratory rate, oxygen saturation, blood gas, and, of course, their ability to speak. Always keeping LEP patients in mind, I wondered what impact language discrepancies would have on the rates of intubation. Right off the bat, this sounded difficult to study, but I dove into the literature nonetheless. After spending some quality time with Google Scholar, I found 2 studies that showed increased intubation rates among LEP patients:

• “[49] percent and 38 percent of Spanish and English speaking individuals, respectively, were intubated for less than 48 hours.”
• “Significant risk factors identified for children requiring intubation, compared to those who did not require intubation, were…language barrier (O.R. 3.3; 95% C.I. 1.1, 10.6).”

Not surprisingly, LEP patients are being intubated more than their English speaking counterparts. It would be interesting to see the effect of interpreters on this trend. Having interpreters more readily available could refine our ability to assess patients’ respiratory status and prevent unnecessary intubations.