The Impact of Watching Cartoons for Distraction During Painful Procedures in the Emergency Department

Objective: The purpose of this study was to determine whether the viewing of cartoons in the acute care setting reduces the perception of pain by pediatric patients. Methods: A convenience prospective study of pediatric patients in pain was performed at a community teaching level I pediatric and adult emergency department, with 44,000 patient visits per year. The inclusion criteria for entry into the study were any child who presented to the emergency department in acute pain from any cause. The younger children were randomized to watch a Barney cartoon in Spanish or English, and the older children were randomized to view a Tarzan cartoon in Spanish or English. The younger children were assessed 5 minutes before the procedure, during the procedure, and 5 minutes after the procedure using Poker Chip Tool and Faces Scale. The older children were assessed at the same time interval using self-reporting and a visual analog scale. The study was internal review board approved. A difference of 20% or greater was considered a significant difference. The data were analyzed using a general linear model-repeated measures a priori level of significance of P < 0.05. Results: There was a significant difference within subject effects: F-1 = 9.268, significant at 0.03, with observed power at 0.85 or 85%, with the alpha set at 0.05 or less. A comparison of the groups revealed that there were no differences in the causes of pain (F-1 = 0.301, P = 0.585), pain duration (F-1 = 0.062, P = 0.084), or type of anesthesia, if used (F-1 = 0.064, P = 0.804) between groups. This lack of difference was upheld for age (F-1 = 3.0407, P = 0.068), race (F-1 = 0.537, P = 0.466), and sex (F-1 = 0.002, P = 0.964). Conclusions: The finding that cartoon viewing was effective does illustrate 1 more pain relief tool for use in the ED when pediatric patients present. It is useful because of the fact that it does not interfere with assessment of patients' presenting or underlying problems. The need for more ways in which to address pediatric pain persists.