Emergency Department distraction therapy for pain and anxiety in paediatric patients: A systematic review & meta-analysis of techniques potentially suitable for the prehospital setting

Tarsh Robinson, Ashleigh J. Delorenzo, Stuart C. Howell, Peter Alistair Cameron, Amanda Stock, Karen L. Smith, Kathryn J Eastwood

Research output: Contribution to journalMeeting Abstractpeer-review


BACKGROUND AND AIM: Distraction therapies are widely used to manage pain and anxiety in paediatric emergency departments (ED). Paediatric patients also comprise up to 13% of some ambulance services workloads yet only a single study exists outlining the ad-hoc use of paramedic-initiated distraction therapy. Building rapport with frightened, unwell children is challenging for paramedics, but is essential to facilitate rapid assessment and care. This review aims to identify effective ED distraction techniques potentially suitable for use in the prehospital setting for paediatric patients.

METHOD: Databases and grey literature sources including Ovid Medline, EMBASE and CINAHL and Google Scholar were searched from their beginning to October 2021. English language interventional or observational studies were included if they reported on distraction techniques suitable for use in the prehospital setting, paediatric ED presentations, and pain and/or anxiety.

RESULTS: Of the 4,054 records screened, 27 met the eligibility criteria. Twenty randomised trials and seven interventional studies involved children aged three months to 18 years. Distraction techniques were digital, non-digital and environmental adaptations and included virtual-reality, cartoons, music, vibration devices, bubble-blowing and ambient lighting. Ten studies reported significant reductions in self-reported pain and seven for self-reported anxiety. Some reported reduced pharmacological administration and improved patient cooperation, and parent and/or healthcare provider satisfaction when using distraction. Studies were highly heterogeneous with 17 distractors and 21 pain and/or anxiety measurement tools used.

CONCLUSIONS: A range of effective distraction techniques exist in paediatric EDs that may be suitable for the prehospital setting to manage pain and/or anxiety.
Original languageEnglish
Article number11S
Number of pages1
JournalPediatric Critical Care Medicine
Issue numberSupplement 1
Publication statusPublished - Nov 2022
EventCongress of the World Federation of Pediatric Intensive & Critical Care Societies 2022 - Virtual
Duration: 12 Jul 202216 Jul 2022
Conference number: 11th

Cite this