Funding outcome

There is a substantial need to better manage pain associated with IV insertions, especially in children, as it is one of the most common procedures performed within medical facilities. Although anesthetic creams or sprays are often applied, their effectiveness may be limited, especially under time constraints, and can even cause blood vessels to constrict, making it more difficult to locate the vein and perform the procedure. Distraction therapy is an emerging area of interest, given that it can be easily employed and is a great alternative in situations where drug management of pain is not possible, such as allergies. We are examining iPads as a form of distraction to better alleviate the pain and distress in children receiving an IV, as compared to the current standard of care which is usually an anesthetic cream, only. The iPads are pre-loaded with games and other activities, and can be constantly updated at a minimal cost. The study will be conducted as a randomized control trial, where the use of an iPad (with standard anesthetic cream) or standard anesthetic cream alone is randomly assigned to children coming into the emergency department. Eight children will be video recorded during their IV insertion, and the videos will be analyzed for pain scores and eight signs of behavioral discomfort for each 15 second interval using a metric known as the Observational Scale of Behavioral Distress - Revised (OSBD-R). These signs of distress include information seeking, crying, screaming, physical restraint, verbal resistance, seeking emotional support, verbal pain or flailing. We expect that adding iPads as distraction therapy will be an equally efficacious if not a better means to minimize the pain and distress associated with IV placements as compared to anesthetic creams, alone. We hope to implement iPad distraction therapy in local pain management protocols and to disseminate this knowledge to other pediatric emergency departments across Canada through collaborative networks.