268 Vr ICU Feasibility Overview
268.1 Summary
- Immersive Virtual Reality
- Gap:
- Enrollment Flow
- Interventions
- Outcomes:
- VR: immersive (headset) vs non-immersive (computer game)
- Immersion is the experience of being absorbed (termed, ‘presence’), forgetting their embodied presence and thus responding as if the environment is real.
- ICU Use cases: Relaxation (several feasibility studies), Cognitive/physical mobilization (1 RCT), Distraction/pain control (1 RCT pre-op), Delirium, Sleep (1 +RCT)
- →all are small, variable definitions/procedures, limited generalizability (barriers likely local)
- Under-replicated
- Barriers likely local
- Provider and Patient perceptions under investigated: is there a gap?
268.2 Slide outline
268.2.1 Slide 1
- Immersive Virtual Reality
- VR: immersive (headset) vs non-immersive (computer game)
- Immersion is the experience of being absorbed (termed, ‘presence’), forgetting their embodied presence and thus responding as if the environment is real.
- ICU Use cases: Relaxation (several feasibility studies), Cognitive/physical mobilization (1 RCT), Distraction/pain control (1 RCT pre-op), Delirium, Sleep (1 +RCT)
- →all are small, variable definitions/procedures, limited generalizability (barriers likely local) ### Slide 2
- Gap:
- Under-replicated
- Barriers likely local
- Provider and Patient perceptions under investigated: is there a gap?
- Is participation actually lower than other types of interventions (vs general research effect?
- Who participates?
- Aims:
- Determine if VR devices are usable in our ICU
- Assess the logistical barriers
- Understand current provider (RN) and patient perceptions
- Do they change pre-post?
- Barriers
- Patient
- Providers
- System
- Apprehension
- Loss of control?
- Digital divide?
- “Cyber Sickness”
- Isolation
- Competing goals
- Skepticism
- Perceptions re: pt
- Ethical? (delirium)
- Competing tasks
- Equipment ### Slide 3
- Enrollment Flow
- Inclusion
- Exclusion
- 18+
- No severe visual/auditory impairments
- No ID precautions
- Awake/Alert, Eyes open for 30s
- Inability to provide informed consent
- Head/facial abnormality precluding headset
- Psychotic d/o
- Recent MDD, Epilepsy, TBI
- Admission for OD ### Slide 4
- Interventions
- Apply VR headset:
- content of their choosing,
- aim for 5-15 minutes
- Apply Biopac:
- ppg, oximeter, plethy belt, ekg
- No EHR, No Vital Signs ### Slide 5
- Outcomes:
- Single visit, no PHI [minimal risk, oral consent]
- Qualitative Interview:
- Please describe your experience using the VR headset
- In what ways did this help you feel better?
- What problems did you have using this headset?
- How did this compare to what your initial expectations?
- How do you think we could use this in the future with other patients?
- Quantitative:
- Vital signs: HR, SpO2, RR (belt), Adrenergic tone (ppg)
- Mood analysis (pre- and post-)
- RN discrimination/calibration predicting interest.
268.3 Learning objectives
- Immersive Virtual Reality
- Gap:
- Enrollment Flow
- Interventions
- Outcomes:
268.4 Bottom line / summary
- Immersive Virtual Reality
- Gap:
- Enrollment Flow
- Interventions
- Outcomes:
268.5 Approach
- TODO: Outline the initial assessment or decision point.
- TODO: Outline the next diagnostic or management step.
- TODO: Outline follow-up or escalation criteria.
268.6 Red flags / when to escalate
- TODO: List red flags that require urgent escalation.
268.7 Common pitfalls
- TODO: Capture common errors or missed steps.
268.8 References
TODO: Add landmark references or guideline citations.