ADVERTORIAL: Advancing radial ergonomics

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This advertorial is sponsored by Adept Medical.

Outlining Adept Medical’s process for identifying and solving ergonomic issues in the cath lab.

With technological advancements over the last 10 years rapidly changing the scope of atrial treatment, radial has quickly become the access point of choice for clinicians globally. Between 2011 and 2018, radial access adoption for diagnostic angiograms increased from 17.5% to 60.4%, and from 14% to 51.8% for percutaneous coronary intervention (PCI) procedures¹, and this trend is set to rise.

This change of technique has led to clinicians having to adapt the interventional lab environment, making improvements to patient set-up for the radial approach, protecting the clinician, and considering workspace ergonomics. As designers of advanced patient supports, Adept Medical has been collaborating with industry-leading experts to address identified needs in improving the interventional lab working environment.

Adept Medical first launched the STARBoard as part of the STARSystem in 2013. After seeing the need for a device to facilitate ease of radial access during interventional cardiology procedures, the company developed a solution alongside experts in the interventional cardiology field, allowing for quick, effective presentation of the patient’s wrist for radial access. Since its launch in 2013, Adept Medical has successfully placed upwards of 2,600 units of the STARBoard in market globally and experienced a positive uptake for a device to provide ongoing procedural repeatability in the cath lab.

After surveying existing users, spanning from New Zealand to the UK, Adept Medical has gathered insight into the benefits the STARSystem has provided clinicians in the cath lab, when compared to their previous way of working.

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The Adept Medical STARSystem offers an ergonomic procedural position for the safe wire/device manipulation

Wire/device manipulation and security

When first witnessing procedures without a device to manage radial access, Adept Medical noticed that often the equipment and wires would be placed over the patient, causing concern of the wires kinking during advancement, or dislodgement of wires from the access site completely. When using the Adept Medical STARSystem, clinicians can easily position and place the wire for ease of manipulation on the work surface of the STARTable.

In a recent study, completed by Adept Medical, the company found that users of the STARSystem had an 87% satisfaction rate with the ergonomic procedural position of wire/device manipulation and an 83% satisfaction rate with wire/device security when using the STARSystem, compared to not using it.

Ergonomic procedural position for the clinician

Without correct positioning of the patient, the clinician is often left having to bend over to gain radial access and complete wire manipulation, particularly in instances when left-arm access is required. Using a rigid arm board or rolled towels offers little flexibility when considering patient management, and often leaves the clinician restricted in movement throughout the procedure.

The STARSystem has been designed to improve the clinician’s posture by having a rotatable arm board that can be positioned correctly to their working preferences. The left arm support allows radial access to be gained on the left-hand side, with the patient’s arm then able to be draped across the abdomen so the clinician can continue to work as normal on the right-hand side. This allows for better working ergonomics for the clinician, eliminating the need of having to bend over the patient and consequently causing back issues.

In a recent study conducted by Adept Medical, it was discovered that users of the STARSystem have an 81% satisfaction rate in the ergonomic procedural position of back straightness using the device, compared to when not using it.

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The Adept Medical STARSystem handle design provides reassurance for the patient, limiting movement during radial access procedures

Managing patient restlessness and movement

During procedures where the patient is under conscious sedation, the risk of restlessness and movement is a concern for clinicians who manage patient safety and imaging outcomes.

After understanding the requirements of the clinician, Adept Medical noticed that patients often need a security reminder to avoid excess restlessness and movement. The handle design of the STARSystem allows the patient to grip an object which provides reassurance throughout the procedure and therefore limits movement compared to not using any methods of patient security. The concaved channel also assists with forearm containment preventing it rolling sideways.

In Adept Medical’s recent study, the company found that clinicians had a 81% satisfaction rate in the STARSystem’s ability to control patient restlessness and movement when compared to their previous method.

Gaining hyperextension of the wrist for access

One of the STARSystem’s key features is its ability to present the patient’s wrist quickly and effectively for proximal radial access when hyperextension is required for ease of puncture. The STARSystem handle is designed to be manipulated to rotate the patient’s wrist from a medially rotated position to a hyperextended position, allowing the radial artery to be presented for puncture. This can often be a cumbersome process without having the degree of manipulation and rotation that the STARSystem provides.

In Adept Medical’s recent study, clinicians had an 85% satisfaction rate in the STARSystem’s ability to hyperextend the patient’s wrist using the device, when compared to their previous method.

Product set-up time when performing left and right arm radial access

Having to create custom solutions for each procedure to set the patient up for radial access is less than ideal. Rolling towels for support, or taping patients to homemade arm boards is a lengthy process for the clinical team, affecting the time to set-up and procedural repeatability. These solutions offer less procedural flexibility, which can also cause delays in gaining access to begin the procedure.

The length of the STARSystem adapts to each patient’s size once they grip the handle. Adept Medical designed the STARBoard to allow for multiple levels of adaptability to comfortably suit most patient sizes.

Clinicians in Adept Medical’s study rated their level of satisfaction with product set-up time when performing right arm and left arm radial approach at 77% and 75% respectively using the STARSystem compared to their previous method.

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The Adept Medical STARSystem presents the patient’s wrist effectively for proximal radial access when hyperextension is required for puncture

The solution

Adept Medical’s development journey of designing a complete radial solution for left and right access has been one derived from strong clinical input. With Adept Medical adopting a solution when radial access was first gaining traction, it allowed the company to understand pain points and offer benefits to a technique that was novel for many clinicians.

According to the company, its findings show that the STARSystem forms a complete and effective ergonomic solution that offers benefits to the clinician during radial access for both patient management and clinician workflow and comfort.

All of Adept Medical’s patient positioning equipment and operator supports are proudly designed and manufactured at the company’s site in New Zealand.

 

References:
1. Doll, J, Beaver, K, Naranjo, D, et al. 2022. Trends in Arterial Access Site Selection and Bleeding Outcomes Following Coronary Procedures, 2011–2018. Circulation: Cardiovascular Quality and Outcomes.


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