Non-medicinal management of pain during dressing rehabilitation in an outpatient clinic in a burnt child. 
My subject deals with distraction during painful care in children burnt
in order to reduce the pain and that the care takes place with serenity.
My problem is: "Does the use of a non-medicated method improve the
child's comfort as well as a considerable reduction in the pain when
performing his burn dressing? "
As far as the research question is concerned, I turned to what the effect
of analgesics on the child burned in the long term care. Indeed, is it
possible to use in parallel other means without side effects? Or to
include them in painful outpatient care?
Hence stemmed, among other things, my general objective that is to be
able to realize a decision tree for the care team working with children
burnt as well. My operational objectives are, first of all, to improve the
comfort and the conditions in which the care for burnt children is
carried out, and thus to be able to integrate distraction methods into
painful care. All this with one and only goal: to win the confidence of
the child so that he can come without fear for his care.
In order to carry out my study, I opted for a descriptive method. This
method consists in having an adapted approach when a theme is not
approached. In order to carry out my study, I first set up objectives, and
in this way, elaborate my initial question. Then I carried out various
literary searches on the subject by exploiting books and websites. I was
able to start putting up theory with the different variables of the
subject. As I was able to realize, multimedia distraction has hardly
been the subject of any study. That's why I had to find out about
American sites. I then created an observation grid. I had to limit my
population to children between 3 and 12 years old. At the end of my
observation, I analyzed and interpreted my results. Finally, for the good
of the patient but also of the care team, I realized a decision tree
resuming a procedure of care highlighting the use of distraction by
virtual reality.
The tool I used is an observation grid that shows the age of the child,
the medication used, the time of the dressing, the type of pain scale, the
type of diversion, The time of distraction and its effectiveness, the
result of this diversion, and in the case of a positive result, the intensity
or non-existence of this pain.
I carried out my study on 8 children and the distraction could only
effect on 5 of them.
I spent two weeks at the Reine Astrid Military Hospital in the Burns
Center, one week in consultation and another one in One Day Clinic. I
realized my technique of distraction on 8 different children of which 7
in consultation and one in One Day Clinic. Their age varied between 3
and 12 years. At the end of the experiment, I was able to interpret my
data and create a decision tree for the healthcare team to enable them to
carry out an adapted care procedure that would include virtual reality
distraction and a liaison card .
I can conclude from my observations in the burn center that I have
succeeded in highlighting the fact that pain is a very important factor to
be taken into account in the overall management of the burned patient.
It is necessary that the patient takes his painkillers before each visit in
consultation so that the care can happen with serenity. Moreover, for
children, this induces a technique of escape which proves to be a
primary factor because this can reduce or even eliminate the pain when
replacing the dressing.
As a means of distraction, I opted for multimedia with virtual reality
headset, GSM with games appropriate to the age of the child.
I used two different scales of pain depending on the age of the child to
judge their pain rate and whether distraction could have effect.
The psychological dimension of the child according to its age in the
face of pain also plays a role.
Following the realization of the distraction on 8 children, this one
worked on 5 children. From there I was able to deduce that when the
second degree deep burn is the child is sent to the One Day Clinic to
undergo a more aggressive debridement and receive medication
inducing sedation. The distraction could not therefore have its effect. If
the child has not received his painkillers and the burn is very deep,
there too the distraction could not work. If the parent accompanying
the child reacts negatively, the distraction will not function properly.
I can infer that distraction is a very good non-drug way to reduce pain
in the burned child if all the conditions are met.
It was a very rewarding experience, I was able to discover the
management of a patient burned by health professionals.

Non Medicinal Pain Treatment for Infant Burn-Victims While Dressing the Wound.