535 - Virtual Reality as an Adjuvant Therapy for Sickle Cell Vaso-Occlusive Crisis in the Pediatric Emergency Department
Monday, April 28, 2025
7:00am – 9:15am HST
Publication Number: 535.7076
Mary Ball Markow, University of Mississippi School of Medicine, Jackson, MS, United States; Matthew W. Maready, University of Mississippi School of Medicine, Jackson, MS, United States; Cynthia Karlson, University of Mississippi School of Medicine, Jackson, MS, United States; Md Abu Yusuf Ansari, University of Mississippi Medical Center, Jackson, MS, United States
Assistant Professor University of Mississippi School of Medicine Jackson, Mississippi, United States
Background: Sickle cell vaso-occlusive crisis (VOC) is a common reason that pediatric patients with sickle cell disease visit the pediatric emergency department (PED). For these patients, treatment in the PED can add a level of anxiety to an already stressful experience. The standard of care for VOC currently includes opioid therapy and non-steroidal anti-inflammatory drugs. One adjunct currently being studied to improve experiences for patients in the PED is the use of virtual reality (VR) to reduce the patient experience of pain. Objective: The objective of this study was to add virtual reality (VR) therapy to the standard of care with the goal of decreasing pain scores, admission rates, PED length of stay, and time to disposition. Design/Methods: The study had two separate arms. A retrospective chart review of patients receiving standard of care served as the historical control arm. A prospective convenience sampling of patients receiving VR therapy in addition to standard of care served as the trial arm. Patients for both study arms were subject to the same inclusion criteria (age 6-21 years, diagnosis of sickle cell VOC at PED visit) and same exclusion criteria (non-VOC pain, fever, respiratory distress or acute chest syndrome, complaint of headache/nausea/dizziness during visit, history of seizures). Patients in the trial arm completed pre-VR and post-VR surveys. The mean pain scores, number of patients admitted, PED length of stay (time from arrival to discharge to inpatient unit or home), and time to disposition (time from arrival to admission decision) were compared from each arm, and the Wilcoxin rank sum test was used to determine statistical significance. Finally, the patients in the trial arm were asked if they would use VR goggles in the future and were screened for potential side effects that may have arisen from the use of VR. Results: A total of 101 subjects (prospective, n=17 and retrospective, n=84) were included in this study. Neither the primary outcomes (pain scores and patient disposition) nor secondary outcomes (PED length of stay and time to disposition) met statistical significance when the two arms were compared. However, 94% of patients on the post-VR survey indicated that they would like to participate in VR again.
Conclusion(s): While the data did not show evidence that VR decreased acute-on-chronic pain scores, hospital admission rates, PED length of stay, or time to disposition, patients who utilized VR indicated that they desired to use it again in the future. Thus, it may be hypothesized that VR satisfaction decreases patient suffering and overall improves the experience even in pain.
