This toolkit supplements professional interpreters. It never replaces them.
This perioperative Spanish communication toolkit helps CRNAs and SRNAs provide simple directions, simple yes-or-no questions, orientation, and reassurance to Spanish-speaking patients with limited English proficiency (LEP). It is designed for point-of-care use via QR code or as an installable app on a mobile device in the operating room. It supplements — and never replaces — professional medical interpreters, who remain the gold standard for all complex, high-stakes, and consent-required communication.
✓ Use the toolkit for these situations
✕ Call a professional interpreter instead
Preoperative orientation"You are going to the operating room." / "I am here with you."
Informed consentAnesthesia risks, benefits, and alternatives must be interpreter-supported
Induction cueing"Take a deep breath." / "Count back from 10."
Risk disclosureComplications, medication reactions, and adverse event discussions
Intraoperative reassurance"Everything is going well." / "You are safe."
Medical history and anesthesia assessmentAllergies, medications, past anesthesia history, preoperative screening
Emergence cueing"Open your eyes." / "Take a deep breath. Surgery is over."
Treatment decisionsAnesthesia plan changes, regional vs. general, or plan modifications
PACU reorientation"You are in the recovery room." / "Rate your pain 1–10. Do you feel nauseous?"
Patient-initiated unclear communicationIf a patient says something you cannot independently interpret from context
Any complex or high-stakes exchangeWhen in doubt — always call the interpreter
Select your patient
Spanish is a gendered language — many words and phrases take a masculine or feminine form. Please select which form fits best for your patient.
No patient selected yet.
A note on language: Spanish grammar assigns a masculine or feminine form to many words, so this toolkit offers both to help you communicate clearly. These are grammatical categories, not assumptions about identity. Choose the form that fits your patient — you can switch anytime using the toggle in the corner — and when in doubt, or when a patient shares a preference, follow their lead or ask your interpreter.
Provider-Initiated
Clinical Judgment Flow
Patient-Initiated
Clinical Judgment Flow
Introductions
Greetings & Introduction · General Phrases
English
Spanish — hover/tap for pronunciation
Phonetic key: CAPITALIZED syllables = primary stress · 'y' = English 'y' in 'yes' · 'h' is silent · 'v' sounds like 'b' · 'j' sounds like 'h'
If the patient initiates complex communication — stop and call the interpreter. These phrases are for simple communication only.
Phonetic key: CAPITALIZED syllables = primary stress · 'y' = English 'y' in 'yes' · 'h' is silent · 'v' sounds like 'b' · 'j' sounds like 'h'
If the patient initiates complex communication — stop and call the interpreter. These phrases are for simple communication only.
Preoperative Phrases
Placing an IV · Pre-op Sedation
English
Spanish — hover/tap for pronunciation
Phonetic key: CAPITALIZED syllables = primary stress · 'y' = English 'y' in 'yes' · 'h' is silent · 'v' sounds like 'b' · 'j' sounds like 'h'
If the patient initiates complex communication — stop and call the interpreter. These phrases are for simple communication only.
Transfer to OR
Leaving Pre-Op · Transfer to OR · Arrival to OR
English
Spanish — hover/tap for pronunciation
Phonetic key: CAPITALIZED syllables = primary stress · 'y' = English 'y' in 'yes' · 'h' is silent · 'v' sounds like 'b' · 'j' sounds like 'h'
If the patient initiates complex communication — stop and call the interpreter. These phrases are for simple communication only.
Positioning Phrases
Positioning · Supine · Sitting Position · Lateral Position · Prone Position
English
Spanish — hover/tap for pronunciation
Phonetic key: CAPITALIZED syllables = primary stress · 'y' = English 'y' in 'yes' · 'h' is silent · 'v' sounds like 'b' · 'j' sounds like 'h'
If the patient initiates complex communication — stop and call the interpreter. These phrases are for simple communication only.
Monitors Phrases
Placing Monitors
English
Spanish — hover/tap for pronunciation
Phonetic key: CAPITALIZED syllables = primary stress · 'y' = English 'y' in 'yes' · 'h' is silent · 'v' sounds like 'b' · 'j' sounds like 'h'
If the patient initiates complex communication — stop and call the interpreter. These phrases are for simple communication only.
Induction Phrases
Induction
English
Spanish — hover/tap for pronunciation
Phonetic key: CAPITALIZED syllables = primary stress · 'y' = English 'y' in 'yes' · 'h' is silent · 'v' sounds like 'b' · 'j' sounds like 'h'
If the patient initiates complex communication — stop and call the interpreter. These phrases are for simple communication only.
Emergence Phrases
Emergence & Awakening
English
Spanish — hover/tap for pronunciation
Phonetic key: CAPITALIZED syllables = primary stress · 'y' = English 'y' in 'yes' · 'h' is silent · 'v' sounds like 'b' · 'j' sounds like 'h'
If the patient initiates complex communication — stop and call the interpreter. These phrases are for simple communication only.
Transfer to PACU Phrases
Transfer to PACU · Arrival to PACU
English
Spanish — hover/tap for pronunciation
Phonetic key: CAPITALIZED syllables = primary stress · 'y' = English 'y' in 'yes' · 'h' is silent · 'v' sounds like 'b' · 'j' sounds like 'h'
If the patient initiates complex communication — stop and call the interpreter. These phrases are for simple communication only.
MAC Cases
During the Procedure · Reassurance
English
Spanish — hover/tap for pronunciation
Phonetic key: CAPITALIZED syllables = primary stress · 'y' = English 'y' in 'yes' · 'h' is silent · 'v' sounds like 'b' · 'j' sounds like 'h'
If the patient initiates complex communication — stop and call the interpreter. These phrases are for simple communication only.
Spinal Phrases
Reassurance · During the Block · After the Block
English
Spanish — hover/tap for pronunciation
Phonetic key: CAPITALIZED syllables = primary stress · 'y' = English 'y' in 'yes' · 'h' is silent · 'v' sounds like 'b' · 'j' sounds like 'h'
If the patient initiates complex communication — stop and call the interpreter. These phrases are for simple communication only.
Epidural Phrases
Reassurance · Positioning · During the Block · Threading the Catheter · If You Feel a Zing · Test Dose · After the Block · Follow-Up
English
Spanish — hover/tap for pronunciation
Phonetic key: CAPITALIZED syllables = primary stress · 'y' = English 'y' in 'yes' · 'h' is silent · 'v' sounds like 'b' · 'j' sounds like 'h'
If the patient initiates complex communication — stop and call the interpreter. These phrases are for simple communication only.
Suggestions
Help Us Improve This Toolkit
Have a phrase you use often that isn't here? Notice a translation that could be better, or something that isn't working right? Tell us — your feedback shapes the next version.
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Suggestions are sent to the toolkit developers. Please don't include any patient information.
About This Toolkit
An Evidence-Informed Toolkit · University of Puerto Rico Medical Sciences Campus
Developers
Elizabeth Malfaro, RRNA, BSN, RN
Daniel Negrón Guzmán, RRNA, BSN, RN
Native Spanish-Speaking CRNA Reviewers
Phrases were written in neutral, regionally unmarked Spanish and reviewed by the following native Spanish-speaking CRNAs, who represent Caribbean, Mexican, Central American, and South American backgrounds:
Dr. Juan Rodriguez Sanchez, DNP, CRNA
Dr. Albert Albors, DNP, APRN, CRNA
Dr. Wilfredo Velasco Vargas, DNP, CRNA
Dr. Wendy Mancia, DNP, CRNA
Dr. Lina Borrero Gonzalez, DNP, CRNA
Theoretical Framework
ACE Star Model of Knowledge Transformation (Stevens, 2004, 2015).
References
Luan-Erfe BM, Erfe JM, Briski D, et al. Limited English proficiency and perioperative patient-centered outcomes: A systematic review. Anesthesia & Analgesia. 2023;136(6):1096–1106.
Joo E, Fernández A, Wick EC, Moreno Lepe G, Manuel SP. Association of language barriers with perioperative and surgical outcomes: A systematic review. JAMA Network Open. 2023;6(7):e2322743.
Dhaliwal J, et al. Communication barriers and perioperative anxiety in patients with limited English proficiency: A narrative review. Journal of Perioperative Practice. 2025;35(10):443–449.
Shebl E, et al. Preoperative anxiety and anesthetic outcomes: A systematic review and meta-analysis. Journal of Clinical and Translational Science. 2025;9(1):e33.
van Lent LGG, et al. Communication strategies for patients with limited language proficiency: A systematic review using GRADE. Patient Education and Counseling. 2025;136:108767.
Heath M, et al. Interpreter services and language-concordant care for migrant populations: A systematic review. Journal of Migration Health. 2023;7:100162.
Pai S, et al. Language discordance in anesthesia care: A scoping review. Patient Education and Counseling. 2026;147:109540.
Rosendahl S, Larsson H. Digital communication tools in transcultural nursing care: A qualitative systematic review. Journal of Transcultural Nursing. 2024.
Silvera-Tawil D, et al. Pre-translated phrase tools and communication parity for patients with limited English proficiency. JMIR Nursing. 2021;4(3):e19709.
Park J, et al. Healthcare anxiety and bilingual provider preference among Spanish-speaking patients: A cross-sectional structural equation model. American Journal of Health Promotion. 2026.
Mano M, et al. A perioperative Spanish communication badge card: A quality improvement report. APSF Newsletter. 2024.
Title VI of the Civil Rights Act of 1964 requires healthcare institutions receiving federal funding to provide meaningful language access to LEP patients. This toolkit supports that obligation.
