A resident physicist at King’s College Hospital, Jonathan Ashmore, keeps a pair of sound-cancelling headphones on his desk. He dons them every time a very young patient arrives at the MRI scanner in the room next door, to drown out the sounds.
“Sometimes the parents are the worst part – and the kids read off of them,” Ashmore tells WIRED.
It’s an unfortunate side-effect of any medical procedure involving a young child; the child may be confused, scared or simply not stay still enough. The younger the child, the more chance there is they won’t comply and either have to return another day or in serious circumstances, where a scan is vital, receive a general anaesthetic. These situations are clearly distressing for the child, their parents and the medical team trying to help. Ashmore, unhappily listening to this conflict from his office next door, decided to build a tool that would help everyone: a space helmet.
“It started with a bike helmet, and Google Cardboard,” he tells WIRED. “Before they come into the room, the radiographer offers them the helmet and asks them if they would like to fly through space.” Using a free virtual reality space flight app, the child is drawn into an immersive environment and they do not notice the anaesthetic being administered. “I made a second one, an aqua helmet. They go underwater and snorkel and there is a valve for the anaesthetic gas. One little girl pretended she was swimming and told us she saw a dolphin – she swam over to the anaesthetic station and didn’t even notice.” It’s a simple hack to distract the child, but with infinite benefits for their health and happiness.
Ashmore talks about intervening as early as possible in the “spiral” that can occur when working with young children. If they are regular hospital visitors, it can get to the point the child refuses to even leave their home for an appointment.
The space and aqua helmets are currently on trial but Ashmore and King’s College Hospital have today unveiled a fully-formed and potentially scalable tool that’s already helping children prepare for MRI scans. The My MRI at King’s app designed by Ashmore, learning technologist Jerome Di Pietro, and a play therapist at the hospital has been launched free on the Play Store. It takes users on a 360-tour of the hospital and the MRI scanner that will ultimately carry out their scan. More than 18 months in the making and just out of beta, the footage is shot from the perspective of the child, and an easy-to-use introduction animation lets them navigate a map of the different areas, from the hospital to the waiting room and the scanner itself.
“There are mock scanners kids can use to prepare themselves, but these can cost £10,000 and take up a whole room in a hospital,” Ashmore said at a demonstration of the app at the Future Laboratory in Shoreditch, east London. “I wondered if would be able to create something that I can give to kids and a play specialist to show them the journey.”
The first obstacle was getting the footage.
“Normally anything you put in an MRI scanner breaks.” Ashmore had to tape a Gear 360 camera to the MRI to take the footage. After complaints that a key scene felt completely wrong – when looking down from the 360-degree view, a human body was missing – Ashmore used some clothes and shoes belonging to the radiographer’s child to make up the appearance of a person. The wearer has the full experience, including the incredibly loud banging of the electrical current in the scanner booting up.
The entire experience is tailored to the hospital, with real staff manning the reception desk and the MRI room. “But any hospital could use it,” says Ashmore. Hospitals could either use it as is or upload their own videos. There is also a tablet version of the app for any patient with neurological issues that might prevent them from using VR.
Ten-year-old Matthew Down, on hand at the launch, has to have annual MRI scans after undergoing surgery to alleviate a buildup of fluid on his brain in September 2014. He tested the app while in beta, and said: “I was really worried before my first scan because I didn’t know what to expect, even though my Dad explained I couldn’t imagine what it would be like. I think the app is really helpful as it shows you what to expect and it feels like you are inside the machine.”
Consultant paediatrician in Paediatric Neurology at King’s, Dr Darshan Das added: “So far the app has had some really positive feedback and I can see it has the potential to significantly relieve anxiety and prevent the need for children to undergo an anaesthetic in many cases.”
Throughout the trial, Ashmore had been posting Google Cardboards out to children ahead of their scans to get feedback. But there are now 20 hardier VR headsets in the hospital, that will be used by play therapists when a child is particularly anxious. Eventually, Ashmore would like to see the headsets tethered in waiting rooms. A link to the Play store will also be included in appointment letters to children identified as being the most anxious (an iOS version is in the works), but Ashmore wants it to be included as standard in all letters eventually. The footage has been uploaded at a lower resolution than originally planned, so it can be used on phones of differing quality, and Ashmore suggests other hospitals could even upload their footage to YouTube and send links to those videos in appointment letters if they did not want to go down the app route. “Guy’s and St Thomas’ emailed me last night and really want to use it,” he said.
There is a version for adults “in the pipeline”, too, and Ashmore believes there are applications for different versions of the app targeting surgery, biopsies and more. “These can be extremely traumatic for children.” VR applications already exist for fighting PTSD, phobias and more.
But for now, he is working on perfecting space flight in south-east London.
More information: WIRED