Using a tablet computer during pediatric procedures: a case series and review of the "apps"

Children who require procedures and interventions that might be painful or anxiety provoking often require physical restraint, procedural sedation, or both. Nonpharmacologic distraction techniques have been shown to be a helpful adjunct in these situations and can decrease or even eliminate the need for restraint or sedation. We present a case series of children who successfully underwent painful procedures using no restraint or sedation, but rather, distraction with the Apple iPad. We are finding this device to be increasingly useful in the management of pain and anxiety in the pediatric emergency department. We review several available applications (also known as "apps") available on this device with particular attention to features that assist providers in selecting appropriate ones by age, developmental stage, and type of procedure.