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There are significant disparities in health status and access to health care in King County, Washington. Poverty, discrimination, and limited English proficiency (LEP) affect access to health care and insurance coverage. Uninsured individuals disproportionately turn to emergency medical services (EMS) for health care services and as such, EMS providers are at the front lines in providing care to those most in need.

In 2014, 21.2% of King County’s residents were foreign-born and of these individuals, 26.4% of King County residents ages 5 and older spoke a language other than English at home.

Research shows that LEP communities in King County experience unique challenges in accessing 9-1-1 related to communication barriers and cultural differences.

Resources for CPR, heart attacks and 9-1-1

Streaming video of when to call 9-1-1 created by students with the School of Public Health, University of Washington, 2017.

Chinese novella on calling 911 and performing CPR during an emergency.

The graphic novella, "How to Save a Life", is a story about an elderly Chinese woman who witnesses a cardiac arrest in her home. The story describes how she calls 9-1-1, requests interpreter services and performs telephone-assisted CPR to save her husband’s life.

The novella is written in traditional/simplified Chinese. The script is translated in English starting on page 21 of the novella.

Video on the King County 9-1-1 Call Center and King County Medic One paramedic system in Cantonese Chinese with Chinese and English subtitles. To enlarge video, press the play button then click on the Full Screen icon located on the lower right of the video screen.

Hands-Only CPR flyers in multiple languages including Oromo
CPR Seattle and the Seattle Office of Emergency Management

Hands-Only CPR flyers in multiple languages including Russian
CPR Seattle and the Seattle Office of Emergency Management

Hands-Only CPR flyers in multiple languages including Spanish
CPR Seattle and the Seattle Office of Emergency Management


About VPSI

The Vulnerable Population Strategic Initiative (VPSI) is a team of highly dedicated staff that works in partnership with the University of Washington School of Public Health, emergency response organizations and community leaders.

Their goal is to conduct programmatic, scientific and case-based evaluations to assure that EMS provides the best possible care to all King County residents regardless of race, ethnicity, age, socio-economic status, culture, gender or language spoken.

Contact us

Alan Abe, King County EMS
For questions on 9-1-1, CPR and stroke education workshops for seniors.

Tey Thach, Seattle Office of Emergency Management
For questions about events/workshops on 9-1-1 and CPR education for limited English populations.

William Mace, Seattle Fire Dept.
For questions about events/workshops on fire prevention, 9-1-1 and CPR education for limited English populations.

For other types of inquiries, please use our online form.

Fire Department-Based Pilot Studies

  • City of Renton Sobering Center Pilot:

  • Shoreline Fire Department Pilot Project to connect patients with mental illness or substance use disorders to health care resources:

    • Study Design (2015)
    • Program Evaluation (2017)
      The pilot project was implemented by the Shoreline Fire Department (FD) to test a method of connecting 9-1-1 callers who have mental illness or substance use disorder to health care resources.

  • Seattle Fire Department High Utilizer Individuals Pilot Project: Study Design (2016)
    Across the United States, high utilizing individuals (HUI) of emergency medical services (EMS) are calling 9-1-1 for non-emergent needs with increasing frequency. It is estimated that nationally 5% of emergency department (ED) patients account for 25% of all the visits, and 62% of all ED visits are for avoidable conditions.

  • STAR EMT Scholarship program: Program Evaluation (2016)
    King County Emergency Medical Services Division has sponsored the enrollment of candidates into its EMT Training Program via a scholarship. The purpose of this process evaluation is to understand and describe how the program is meeting its objective to remove three barriers that could dissuade someone from pursing enrollment in an EMT training program and a career in EMS.

  • Vulnerable Adult Pilot Project:

    • Study Design (2014)
      The overreaching goal of the VPSI is to conduct programmatic, scientific and population based evaluations to ensure that the interface between EMS and vulnerable populations leads to better outcomes for vulnerable adults by applying research evidence to practice. The initiative is focused on conducting needs assessments with EMS providers and local populations, identifying and implementing pilot interventions and evaluating the results.
    • Program Evaluation (2015)
      The EMS Vulnerable Adult Pilot Project is a coordinated effort to improve the identification and reporting of vulnerable adult abuse and neglect, to increase care coordination and communication among involved agencies, and to improve health outcomes of vulnerable adults in Seattle, King County.


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