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Virtual reality for intravenous placement in the emergency department-a randomized controlled trial
Ran D Goldman1,2, Amir Behboudi3
1The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Pediatric Emergency Medicine, Department of Pediatrics, University of British Columbia, Vancouver, Canada. rgoldman@cw.bc.ca.
Insights
Virtual reality (VR) effectively reduced anxiety and increased satisfaction during pediatric intravenous catheterization in the emergency department (ED). While pain reduction was similar, VR enhanced the overall patient experience, suggesting its utility in pediatric care.
Area of Science:
- Pediatric Emergency Medicine
- Medical Technology Integration
- Pain and Anxiety Management
Background:
- Virtual reality (VR) is an emerging technology with potential for pain and anxiety management through distraction.
- Intravenous catheterization is a common, often anxiety-provoking procedure for children in emergency departments (EDs).
Purpose of the Study:
- To evaluate if virtual reality (VR) is superior to standard care in reducing pain and anxiety during pediatric intravenous catheterization in the ED.
- To assess the impact of VR on patient and parent satisfaction, procedure efficiency, and overall experience.
Main Methods:
- A randomized controlled trial involving 66 children (aged 6-16) undergoing IV placement in the ED.
- Participants received either VR intervention or standard care (e.g., videos, iPad).
- Outcome measures included pain scores, anxiety levels, satisfaction, number of attempts, and procedure duration.
Main Results:
- VR group showed higher satisfaction with anxiety management (p < 0.007) and rated VR as more enjoyable (p < 0.024).
- Procedure time was slightly shorter in the VR group (5 min vs. 7 min), though not statistically significant.
- While pain and anxiety differences were not statistically significant, VR demonstrated promise as a distraction tool.
Conclusions:
- Virtual reality serves as an effective distraction during pediatric IV catheterization, improving anxiety management satisfaction.
- The findings support the integration of VR systems for managing pediatric anxiety in emergency settings.
- VR enhances the patient experience, making it a valuable addition to standard care protocols.
Abstract:
This study sought to determine whether adding virtual reality (VR) was superior to standard of care alone in facilitating reduction in pain and anxiety among children who underwent intravenous catheterization in the emergency department (ED). Sixty-six children aged 6-16 years who needed intravenous placement received VR, or standard of care in the ED (videos, television, iPad, child life specialist). Outcome measures included change in pain score, level of anxiety, patient and parent satisfaction (pain and anxiety), number of trials, and procedure time. Compared with controls, the intervention group had similar age, sex, number of trials, and anesthetic use. Time of procedure was shorter in the VR group (median 5 min) but this was not statistically significant compared with 7 min for the control group. Pain in the intervention group was lower, even before the procedure. Difference in pain (before and after) and anxiety (after the procedure) were similar in both groups. Satisfaction from anxiety management was higher for the VR group (p < 0.007) and children rated VR significantly more "fun" (p < 0.024).Conclusion: VR was an effective distraction tool and increased satisfaction from anxiety management for this common pediatric procedure, and should be incorporated in management of anxiety in children in the ED setting.Trial registration: clinicaltrials.gov ID NCT03681730, https://clinicaltrials.gov/ct2/show/NCT03681730 What is Known: • Virtual reality is an evolving computer technology that shows some promise in the areas of acute and chronic pain management due to its ability to create effective distraction. What is New: • We report that among children in the emergency setting with intravenous catheterization, satisfaction from the use of VR for anxiety management should support implementation of VR systems for this procedure.
