Children often need procedural sedation in the emergency department during painful procedures (such as reducing fractures). Virtual Reality (VR) is an immersive experience using sight, sound, and position sense. Using VR may enhance distraction during the painful procedure and may reduce attention to pain. VR may also reduce anxiety during sedation induction by reducing providing an alternative stimulus. This study will randomize children (6 - 16 years old) to receive Virtual Reality or standard of care while undergoing procedural sedation. Investigators will measure heart rate, blood pressure, satisfaction (child, parent, provider), amount of sedatives used and compare between the two groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
64
Participants wear a Virtual Reality headset that consists of a ASUS phone and a VOX+ Z3 3D Virtual Reality Headset. The phone runs the VR Roller Coaster app to produce the virtual environment.
BC Children's Hospital
Vancouver, British Columbia, Canada
RECRUITINGChange in Heart Rate as measured by heart rate monitor
The heart rate monitor will consistently display participant heart rate. Heart rate will be recorded at 1 minute intervals. The difference in heart rate from recommended mean heart rate based on age will be calculated and compared between groups.
Time frame: During the procedure at 1 minute intervals
Change in Blood Pressure as measured by blood pressure monitor
The blood pressure monitor will display participant blood pressure. Blood pressure will be recorded at 1 minute intervals. The difference in blood pressure from recommended mean blood pressure (systolic and diastolic) based on age will be calculated and compared between groups.
Time frame: During the procedure at 1 minute intervals
Emergence Phenomenon as measured by yes/no questions regarding participant experience.
Patients will be asked whether they experienced nightmares, day-dreaming, or feeling unwell. Number of patients who experienced these negative emergence phenomenon will be tabulated and compared across groups.
Time frame: Immediately after the procedure and by phone the next day
Satisfaction among Children by global rating scale
Children will be asked "On a scale of 0-10, how did the procedure go?" A score of 0 represents not very well and a score of 10 represents very well.
Time frame: Immediately after the procedure
Satisfaction among Guardians by global rating scale
Guardians will be asked "On a scale of 0-10, how did the procedure go?" A score of 0 represents not very well and a score of 10 represents very well.
Time frame: Immediately after the procedure
Satisfaction among Emergency Staff by global rating scale
Emergency Staff will be asked "How satisfied are you with how the procedure went?" A score of 0 represents not very well and a score of 10 represents very well.
Time frame: Immediately after the procedure
Type and dose of medication
Amount of medication and what medications were used will be gathered from the nursing notes.
Time frame: Intraoperative
Time difference of the procedure
Time the procedure takes to complete with or without VR will be recorded to determine if there is any difference.
Time frame: Intraoperative
Length of stay in the Emergency Department
Length of stay in the Emergency Department will also be recorded. This will be determined by the intake time noted by triage and the discharge time as witnessed by research assistant or, if unseen, by the time noted on the discharge paperwork.
Time frame: Intraoperative
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