This qualitative study aimed to explore the experiences of first responders in communicating with patients with limited English proficiency (LEP) in emergency situations and the impact those language barriers have on their self-efficacy. After the completion of a literature review, 20 first responders (fire, police, EMT, paramedic) were interviewed about their experiences and perceptions of language barriers. These interviews were transcribed and analyzed thematically, resulting in the identification of these main themes: regional language variability, urban vs. rural language resource availability and incentives, differing language needs of police vs. non-police, language barrier impacts on the quality of care received by LEP individuals, cultural understanding vs. language proficiency, desire for a video/facetime translation resource, and the role of children as bilingual translators. Findings suggest that language barriers do have an impact on the self-efficacy of first responders and the quality of care provided to LEP patients, with 50% of participants recalling an experience in which a language barrier impacted the quality of care they provided to LEP patients. Overall, this study contributes to a better understanding of the experiences and challenges faced by first responders in communication with LEP individuals and provides insights into much needed and desired strategies for overcoming language barriers to improve professional self-efficacy and equitable patient care in emergency situations.