iPad as a Distraction Tool During Facial Laceration Repair

Not Applicable

Completed

Brief Summary: Children aged 2-12 presenting to the Rady Children's Hospital San Diego (RCHSD) emergency department with facial lacerations requiring suture repair will be eligible to participate in the study. Participating children will be randomized to standard care versus standard care plus iPad use during the procedure. Children's anxiety levels assessed using a validated scale will be measured from video recordings made of the procedure. Parent and provider satisfaction surveys will be completed following the procedure. The primary study aim is to determine how iPad use affects children's anxiety levels during facial laceration repair. The secondary study aim is to determine how iPad use affects parent and provider satisfaction regarding a child's facial laceration repair. Hypothesis is that iPad use decreases children's anxiety levels during facial laceration repair and increases parent and provider satisfaction regarding a child's facial laceration repair.

Recruitment & Eligibility

Inclusion Criteria

Patients: Male and female children aged 2-12 of all ethnic backgrounds and socioeconomic levels presenting to the emergency department for laceration repair. Children sustaining single, uncomplicated facial lacerations, which can be repaired with basic suture techniques, are eligible for the study. Lacerations repaired using LET cream, lidocaine injection, and LET cream and lidocaine injection are all eligible for the study.
Parents of enrolled patients.
Providers of enrolled patients: Residents, fellows, attendings, and nurse practitioners serving as the primary provider performing the laceration repair.

Exclusion Criteria

Patients: Lacerations to parts of the body other than the face. Children with developmental disabilities. Children with laceration repair requiring sedation. Children with complex lacerations requiring subspecialty repair.
Parents and/or providers of children not eligible or enrolled in the study.
Providers: Medical students performing the laceration repair.

Arm && Interventions

Group	Intervention	Description
iPad	Standard Care	iPad with age-appropriate applications, videos, and music
Standard Care	Standard Care	All study participants will receive standard care, which consists of procedural explanation and preparation by providers, verbal encouragement and comforting by providers and parents, and topical anesthetic (LET) followed by injectable lidocaine administration (whether one or both of these anesthetics will be used will be determined by the provider prior to randomization).
iPad	iPad	iPad with age-appropriate applications, videos, and music

Primary Outcome Measures

Name	Time	Method
Observational Score Behavioral Distress Revised (OSBD-R)	Entire laceration repair procedure	Weighted average Observational Score Behavioral Distress Revised (OSBD-R) scored from videotapes of the entire laceration repair procedure Scale 0-23.5 (0 low/better, 23.5 high/worse)

Secondary Outcome Measures

Name	Time	Method
Parent Survey	Survey administered immediately following the laceration repair	Parent rating of own anxiety during the procedure Likert-based scale 1-5 (1 low/better, 5 high/worse)