• Robyn J McCahill, Cate Nagle, and Patricia Clarke.
• Emergency Department, Mackay Hospital and Health Service, Mackay Hospital and Health Service, 475 Bridge Rd, Mackay, QLD 4740, Australia. Electronic address: robyn.mccahill@health.qld.gov.au.
• Australas Emerg Care. 2021 Sep 1; 24 (3): 174-178.

BackgroundThe objective of this review was to collate, summarise and report evidence on the use of VR as an interventional tool for pain and anxiety management during ED procedures.MethodsGuided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) we searched Medline, Embase, CINAHL, Scopus and PsychInfo databases, grey literature and reference lists of included studies.ResultsFrom 162 articles, 4 fulfilled the selection criteria and demonstrated VR was effective as an intervention for management of pain and anxiety during ED procedures. The level of evidence was variable: 2 randomised controlled trials (RCT); a descriptive study; and a commentary on a literature review. Participants were aged 4-17 years and the sample sizes were small (n = 20, 59, 64). One RCT compared efficacy of VR to 2 other standard of care (SOC) distractors while the other RCT assessed for VR efficacy and safety. All four articles cited benefits of VR distraction as a procedural intervention in ED.ConclusionsA small number of studies involving children undergoing needle insertion in ED found VR to be a safe and effective means of managing procedural anxiety, providing a more effective strategy than standard care. Studies with larger samples, involving different procedures and across age groups are required.Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.

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