The problem. Each year, a surprisingly large number of children get severely burned, via a wide range of accidents (e.g, boiling water cooking spagetti gets spilled and the child is scalded, fires at discos, etc). Opioid analgesics, powerful narcotic pain medication, are very effective for controlling the pain of severe burn patients when they are resting/laying still in their hospital beds. Unfortunately, burn patients must have their burn wound cleaned daily, to prevent infection, and this cleaning process, which often lasts 30 minutes to an hour a day, results in severe to excruciating pain for the child, even when powerful opioid pain medications are used. As their bodies become used to the drugs, higher and higher opioid doses are needed to achieve pain control, but opioid side effects such as nausea and constipation, become more and more of a problem with higher doses, and these side effects limit how much the opioid dose can be increased. As a result, MOST patients report severe to excruciating pain during daily severe burn wound care medical procedures. Day after day. Both during wound care and physical therapy exercises.

Psychological factors can make pain worse. Psychological factors can amplify how much pain a severe burn patient experiences during wound care. Patients can develop stimulus-response conditioning. They learn that wound care is painful, and they become anxious as they are brought into the wound care room. Objects they see in the burn wound treatment room (e.g., scrubtank, tweezers, washcloths, bandages, etc) can make patients anxious. Patients learn to EXPECT pain, even before the nurse arrives to begin the wound care session, the patient gets more and more nervous that the wound care session is going to be painful.

IT solution to pain. The good news is that because psychological factors can INCREASE how much pain patients experience, psychological treatments can also REDUCE how painful patients find their wound care sessions.

Dr. Hoffman will briefly and simply present the results from several key clinical research studies, and laboratory pain studies he, Dave Patterson, Sam Sharar, MD and others have conducted at the University of Washington in Seattle (as well as one study by Bertus Faber conducted at Martini Hospital in the Netherlands).
Hoffman will briefly explain the logic of why immersive virtual reality distraction is so effective at reducing the pain of children during wound care. He will show photos of a couple of custom technologies (VR helmets) he and his colleagues have developed to treat burn pain, and he will show a video clip of a U.S. Soldier using virtual reality pain distraction during physical therapy for a severe combat-related burn injury from a roadside bomb attach on his humvee convoy in Iraq (research being conducted at a large military hospital in San Antonio Texas). Results using SnowWorld for pain distraction are very encouraging. The images of burn patients shown will be suitable for a non-medical audience.

Dr. Hoffman is also helping to pioneer a second line of research, helping therapists put their patients into virtual reality during therapy sessions, to help the patients gradually become more comfortable thinking about the traumatic event they previously experienced (e.g., a terrorist attack on the World Trade Center, or a terrorist attack on a soldiers humvee convoy in Iraq). Preliminary results using WTC World and IraqWorld are very encouraging.

Virtual Reality Therapy is an excellent example of how information technology can be used in hospital settings by creative interdisciplinary teams, to reduce physical and psychological suffering. Researchers are now exploring whether VR therapy can improve medical outcome.
Dr. Hoffman and his team at the University of Washington and Harborview Burn Center in Seattle originated the technique of using immersive virtual reality for pain distraction, and Hoffman is one of several key pioneers developing virtual reality as a technology to amplify the effectiveness of therapists treating civilian and combat-related post-traumatic stress disorder.