A novel technology approach to pain management in children with burns: A prospective randomized controlled trial

Background: Non-pharmacological approaches to supporting young children through painful medical procedures are an essential component of burn pain management protocols. New technology developed from collaborations between healthcare professionals and IT teams can enhance the preparation and distraction approaches used with children. This study follows on from previous studies using such technology, and aim to determine whether levels of pain and distress using a combined preparation and distraction content can be further reduced, and offer more efficient clinical outcomes. Methods: Forty children (3-10 years) undergoing acute burn care procedures were randomized to two groups: (1) Standard Distraction (SD) Group and (2) Multi Modal Distraction (MMD) Group (combined protocol of procedural preparation and distraction). Pain intensity and child distress were measured prior to and during the procedure. Clinical utility end points were also included; length of treatment, days to healing and adverse pain events. Results: A combined MMD protocol significantly reduced pain intensity (p < 0.001) and distress scores (p < 0.001) when compared to SD. Length of treatment (p < 0.05), days to healing and the number of pain adverse events were also reduced (p < 0.05) with the use of the MMD protocol. Conclusions: A combined MMD protocol reduces the pain experiences for young children during burn care procedures. When compared with a previous MMD trial, outcomes reiterated the use of procedural preparation as an essential component of non-pharmacological approaches. In addition to minimizing pain and distress, this innovative technology reduced treatment length and pain adverse events, and may have an impact on reducing days to healing, providing evidence of clinical efficacy and utility. (c) 2010 Elsevier Ltd and ISBI. All rights reserved.