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Packard Children’s anesthesiologists invent safe, fun way to distract children before surgery

Waiting to have surgery can be nerve-wracking, especially if you're a kid. At Lucile Packard Children's Hospital Stanford, pediatric anesthesiologist Sam Rodriguez, MD, wanted to find a fun way to distract his young patients from their fears during the last few minutes before surgery.

Rodriguez was motivated by a desire to help patients feel more comfortable on their way to the operating room, and also by the knowledge that anxiety can delay the induction of general anesthesia, while oral anti-anxiety medications often used in young patients can increase the time it takes to come out of anesthesia after surgery and can prolong recovery. He decided to invent a medication-free alternative.

After some tinkering in his garage, Rodriguez came up with the Bedside Entertainment and Relaxation Theater, or BERT, and asked his friend and fellow anesthesiologist Thomas Caruso, MD, to help put it to use at the hospital. A post from the hospital's blog explains how it works:

BERT consists of a projector and large, white plastic screen, both which are mobile and attach to a patient’s bed with clamps. Patients can choose from a menu of age-appropriate entertainment options ranging from TV shows to movies to music videos.

The immersive media experience also includes an element of theatrics. For example, once inside the OR, the anesthesia team uses BERT to start a countdown as they put the mask on and the patient falls asleep. They will shake the bed and give verbal cues like, “You’re going to smell the rocket fuel now,” and “we’re taking off!” These “induction plays” span several themes, including a deep sea dive, rocket launch blast-off and whimsical My Little Pony and Dora the Explorer adventures.

The team is now gathering data to find out whether families and anesthesiologists note consistent reductions in children's anxiety and need for anti-anxiety medications with BERT. They're also looking for ways to expand its use in other parts of the hospital.

“BERT is where the medically complex work of the surgery process meets the pragmatism of keeping the patient and family comfortable,” said Christine Cunningham, the hospital's director of patient experience.

Previously: Advances in anesthesia make it possible for patients to remain awake and watch TV during surgery, Education reduces anxiety about mammography and Stanford psychologist discusses children experiencing anxiety and how parents can help them
Video courtesy of Lucile Packard Children's Hospital Stanford

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