Nursing News

iPads and Apps are Helping Kids Cope with Pain

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By E’Louise Ondash, RN, contributor 

April 26, 2013 - While many adults decry the negative impacts of technology and electronic games on children, child life specialist Callie Kofoed, MSW, who works in the radiology department at Seattle Children’s Hospital, wouldn’t be without either. Her job is to distract kids and minimize their pain while undergoing procedures, and in her opinion, iPads are saviors.

“I’ve seen the benefits of distraction via technology time and time again,” she explained. “Just five minutes ago, I utilized the iPad to support a child through an IV start.  He was so focused on playing the game that he tolerated the IV start and even kept his arm ‘still as a statue.’  His mother was very worried about how he would cope, but technology, coupled with [a] child life [specialist], came to the rescue.”

Pediatric hospitals across the country are discovering, through studies and personal experience, that electronic games and other entertainment technology are helping their young patients through “some pretty tough stuff.”

“The technology has been a lifesaver,” Kofoed said. “We’ve been using iPads since August and they have been awesome for any exam with catheter. We also have other little tricks, like when the child has to void on a table. It’s hard to pee while lying down, so we bring up [a video of] a waterfall. The iPad doesn’t do my job for me; it enhances what I do.”

Patients at Seattle Children’s also can watch movies while in the MRI scanner to help them cope with a procedure that would otherwise require sedation.

“Other procedures, many that involve catheters, can be completed without anesthesia when child life and technology are involved,” Kofoed said.

Distraction is an important tool when it comes to painful procedures and kids, according to Michael Jeavons, MD, of the Hospital for Sick Children in Toronto. It’s not a matter of tricking the child into ignoring the pain, but “more like inviting the child to shift her focus from the pain to something more pleasant and interesting. As the child’s attention is diverted to something other than the pain, the pain signals are interrupted.”

Studies have shown that some types of distraction are superior to others.

For instance, A 2011 Canadian study looked specifically at how active and passive distractions compared when it came to pain tolerance. Researchers concluded that when subjects are involved with active distraction, like playing a video game, their pain tolerance increased. Passive distraction, like watching a movie, doesn’t work as well.

All of the 40 child life specialists at Texas Children’s Cancer Center in Houston have iPads in their pain-fighting arsenal. 

“Using iPads is how kids learn and how they engage,” said child life specialist Saraben Turner, who is responsible for bringing the devices to the department. “We’ve found during painful times, they have been so helpful in distracting kids.”

Before the arrival of iPads, child life specialists and nurses had a low-tech bag of tricks--books, light-and-sound toys and other distractions--but these things are age specific, so they needed many different ones. The iPad is a one-size-fits-all solution. It has a seemingly infinite number of games and activities, “so you can hit all ages with one device.”

Young patients at the cancer center make repeat visits for painful procedures, and many would kick and fight during a “poke,” when needles or catheters were inserted, Turner explained. “Now they come in and say, ‘Where’s the iPad?’ and sit still. We’ve had phenomenal feedback.”

Nurses and child life specialists sometimes augment the use of the iPad with a device known as a Buzzy, a vibrating bee with wings that are actually ice packs. The cold and vibrations dull the pain of needle insertion when starting IVs or during other procedures requiring needle sticks.

“By using the iPad and Buzzy at the same time, we get non-pharmacological pain management with the Buzzy, and distraction and coping assistance with the iPad,” Turner said.
Tiffany Gray BSN, RN, a pediatric nurse for eight years at the children’s cancer center, often works in tandem with child life specialists. Prior to acquiring iPads about two years ago, music, headphones and age-appropriate toys were used to distract young patients. Children were also encouraged to bring their special blanket or doll to the hospital. They can still bring these things, but “I think the electronic things work better,” Gray said. “We start the games before a procedure like starting IVs, LPs and accessing ports, and the kids are so focused.”

All in all, she added, “the iPads are better and the results more positive.”


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