Reducing Procedural Anxiety in Paediatric Emergency Care

The Challenge

The Emergency Department faced significant challenges around procedural anxiety, particularly during IV cannulation. High levels of patient distress often led to the common use of physical restraint — known as 'wrapping and holding' — to complete necessary procedures. The team needed to find approaches that could reduce the need for physical restraint while enhancing patient comfort, especially for younger children. Any solution would need to be cost-effective and easy for staff to adopt quickly in a fast-paced emergency environment.

The Solution

The Paediatric Emergency Physician first encountered Smileyscope while on fellowship at another major children's hospital, where the team was working to reduce nitrous oxide use. Impressed by its effectiveness in reducing patient distress, they championed its introduction upon returning as a consultant. Implementation involved housing Smileyscope devices in an easily accessible swipe-card room alongside other distress minimisation tools, and initially training a few clinical champions. The department now has three Smileyscope devices, with more being added. Because the technology is used so frequently, new staff quickly see Smileyscope in action and are eager to learn how to use it.

The Impact

Smileyscope has made a measurable difference in the Emergency Department. Physical restraint through wrapping and holding has reduced significantly, with patients calmer and more cooperative during procedures. Staff, families, and patients all report happier, more positive encounters. Anecdotally, sedation use has also reduced. The technology has also boosted staff morale, with the team finding procedures easier and more enjoyable. Smileyscope has become a routinely used tool in the busy Emergency Department, relied upon multiple times each day.

Procedural anxiety is something we see very often. Smileyscope has helped hugely in this area. Patients are calm, everyone is happier — which makes all the difference.

— Paediatric Emergency Physician

Going Forward

The Paediatric Emergency Physician continues to advocate for Smileyscope within the hospital and beyond. More devices are being added to the Emergency Department to support growing demand, and they have been pivotal in the hospital adopting the technology across other departments — credited with six or more units now in use across the hospital and other sites. In their educational role training local, regional and rural services in paediatric care, they include Smileyscope as part of the package of tools that improves paediatric procedures.