Distraction helps kids get stitches in ER

Listening to a CD player or playing a video game may make getting stitches more tolerable for children who come to the ER, new research suggests.

Previous reports have suggested beneficial effects using distraction techniques, but until now no studies have evaluated their ability to facilitate the completion of painful procedures in the pediatric ER setting.

As reported in the journal Pediatrics, Dr. Madhumita Sinha, from Maricopa Medical Center in Phoenix, Arizona, and colleagues assessed the outcomes of 240 children, between 6 and 18 years of age, who were randomly selected to receive a distractor or no distractor while receiving stitches. All of the children received a topical anesthetic and an injectable local anesthetic was given if deemed necessary.

Children in the intervention group were given a choice of a music, video game, or cartoon video distractors. If the child showed no interest in any of these, a certified child life worker offered to read a book or blow bubbles with them.

In children younger than 10 years of age, pain, as assessed by facial grimaces, did not differ significantly between the groups. However, the parent’s perception of pain distress was lower in the distractor group than in the comparison group.

In older subjects, the distractors seemed to have no effect on pain, but were tied to a reduction in anxiety.

Distraction techniques “may have a role in improving the quality of management of procedural pain in a pediatric ER setting,” the authors note. Because such interventions “require minimal training and effort, integrating these techniques into existing pain management protocols might complement standard (drug) therapy in the pediatric ER and even in other outpatient settings.”

SOURCE: Pediatrics, April 2006.

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