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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Virtual Reality | Experimental | Participants are distracted by wearing the virtual reality headset and watching a roller coaster app while undergoing procedural sedation |
|
| Standard-of-Care | No Intervention | Participants are distracted with Standard-of-Care by doctors, nurses, nurse practitioners, child life specialists and/or parents. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Virtual Reality | Device | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Change 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. | 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. | During the procedure at 1 minute intervals |
| Measure | Description | Time Frame |
|---|---|---|
| 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. | Immediately after the procedure and by phone the next day |
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INCLUSION CRITERIA
EXCLUSION CRITERIA
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ran Goldman, MD | Contact | 604-875-2345 | 7333 | rgoldman@cw.bc.ca |
| Name | Affiliation | Role |
|---|---|---|
| Ran Goldman, MD | University of British Columbia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| BC Children's Hospital | Recruiting | Vancouver | British Columbia | V6H 3N1 | Canada |
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| 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. | 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. | 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. | Immediately after the procedure |
| Type and dose of medication | Amount of medication and what medications were used will be gathered from the nursing notes. | 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. | 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. | Intraoperative |