• Esli Osmanlliu, Evelyne D Trottier, Benoit Bailey, Maryse Lagacé, Mélanie Certain, Christelle Khadra, Marisol Sanchez, Corinne Thériault, David Paquin, Casey Côtes-Turpin, and Sylvie Le May.
• Department of Pediatric Emergency Medicine, CHU Sainte-Justine, 3175, Ch. de la Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada. esli.osmanlliu@mcgill.ca.
• CJEM. 2021 Jan 1; 23 (1): 94-102.

ObjectivesIntravenous (IV) procedures cause pain and distress in the pediatric emergency department (ED). We studied the feasibility and acceptability of virtual reality distraction for patient comfort during intravenous procedures.MethodsChildren were randomized to a control (standard care) or intervention group (standard care + virtual reality). Thresholds for feasibility and acceptability (primary outcomes) were determined through a priori established criteria. The level of procedural pain (principal clinical outcome) and distress, as well as memory of pain at 24 h were collected and reported as medians (Q1, Q3) for each group.Results63 patients were enrolled, with a high rate of recruitment (78.8%) and game completion (90.3%). Patients, parents and, healthcare providers reported high satisfaction levels. There were no serious adverse events. Five of the 30 patients (16.7%) exposed to virtual reality reported mild side effects. Self-reported procedural pain (verbal numerical rating scale: 3 (1, 6)/10 vs 3 (1, 5.5)/10, p = 0.75) was similar between groups. Further exploratory clinical measures were reported for the intervention and control groups, respectively: self-rated distress during the procedure (Child Fear Scale: 1 (0, 2)/4 vs 2 (0, 3)/4); distress evaluated by proxy during the procedure (Procedure Behavior Check List: 8 (8, 9)/40 vs 10 (8, 15)/40); memory of pain at 24 h (VNRS: 2 (1, 3)/10 vs 4 (2, 6.5)/10).ConclusionThe addition of virtual reality to standard care is feasible and acceptable for pain and distress management during IV procedures in the pediatric ED. Occasional mild, self-resolving side effects were observed in the intervention group. Self-reported pain during the procedure was similar between groups. CLINICALTRIALS.Gov IdentifierNCT03750578.

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