Sign language can reduce communication interference in Emergency Department.

Sir,

Emergency Department (ED) is a noisy ambience and has excessive noise many a time. [1] It may lead to communication interference and subsequent disruption of complex procedures and decision making. ED has seldom a controlled working environment like Intensive Care Units (ICU) or Operation Rooms (OR). An emergent or urgent patient with uncertain medical conditions with uncertain vital parameters, mostly visits ED accompanied by either lots of family members or many Emergency Medical Services (EMS) Personnel.

There are many unanticipated reactions from families following unpleasant verbal communication amongst HCWs inside ED during resuscitation or so. It makes the families tense, HCWs embarrassed and creates hurdles in communication. If sign language is used, the same can help HCWs communicate right thing in right time without unwitting disclosure. In the era of Covid-19 pandemic, a Covid-19 suspect may enter the ED, where he/she can infect many others. It needs immediate communication to HCWs to use optimal PPEs before performing high risk procedures and take the patient to isolation room. If this is done through non-verbal cues like sign language, an effective communication is made without any disorder. Communication through gesture control is a part of our basic instinct and can stand well as an alternative to sound language without disturbing the normal flow of work.

Uses of sign languages, in particular hand gestures, are not new venture in the practice of surgery inside operation rooms to avoid distraction, although to a very limited extent. Even development of a robotic scrub nurse Gestonurse has been described to support surgeons by passing surgical instruments during surgery as required [2]. Sign language recognition (SLR) systems based on sensory gloves are some innovations to accurately read the sign language and are in practice [3]. Sign language with non-verbal cues can help HCWs convey their messages without tiresome efforts of speaking through n95 face masks inside Covid-19 isolation wards [4]. In practice of Emergency Medicine or Internal Medicine, however it is grossly unexplored and underutilized.

We conclude that regional sign languages enriched with commonly used medical terms of ED can help establish effective clinical communication amongst HCWs while regulating divulgence of restricted information. It needs some motivation and training for HCWs. Additionally, there is need of research in this perspective to further approve or disapprove its utility.

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