Virtual Reality Feasible for Improving Comfort of Pediatric IV Procedures

Researchers from the University of Montreal and CHU Sainte-Justine in Canada have found that using virtual reality in addition to standard care is a “feasible and acceptable” method for managing children’s “pain and distress” during intravenous (IV) procedures.

The team of scientists, led by Dr. Sylvie Le May, PhD, used a randomized controlled trial (Clinical Trial Identifier: NCT03750578) to determine whether virtual reality could improve patient comfort by serving as a distraction in the pediatric emergency department (ED).

IV procedures, such as the insertion of a central venous catheter for the administration of medications, can cause pain, discomfort, and distress among children and finding effective methods for improving patient comfort and satisfaction during these procedures could be useful to pediatric EDs. (The below videos show attempts to improve patient comfort during IV procedures similar to that of Dr. Le May et al, albeit using less-advanced technology, from the mid- and late-2010s.)

Their study, published in the Canadian Journal of Emergency Medicine, involved the random assortment of children to either a control group (standard care) or treatment group (both virtual reality and standard care) and measured the “feasibility and acceptability” of the virtual reality treatment using two primary outcomes- “level of procedural pain and distress” and “memory of pain at 24 hours”- which were based on pre-existing criteria including the Child Fear Scale, Procedure Behavior Check List, and Verbal Numeric Rating Scale.

Children in the control and treatment groups demonstrated similar levels of self-reported procedural pain “(verbal numerical rating scale: 3 (1, 6)/10 vs 3 (1, 5.5)/10, p = 0.75).”

Other measurements of clinical outcome, including “self-rated distress during the procedure,” “distress evaluated by proxy during the procedure,” and “memory of pain at 24 hours,” were “1 (0, 2)/4 vs 2 (0, 3)/4)” (based on the Child Fear Scale), “8 (8, 9)/40 vs 10 (8, 15)/40)” (based on the Procedure Behavior Check List), and “2 (1, 3)/10 vs 4 (2, 6.5)/10)” (based on the Verbal Numeric Rating Scale), respectively.

Among children exposed to virtual reality, five reported mild, self-resolving side effects. The researchers did not record any serious adverse events, and found that healthcare providers, children, and parents “reported high satisfaction levels.”

The authors concluded that using virtual reality in addition to standard care “is feasible and acceptable for pain and distress management during IV procedures in the pediatric ED.”

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