Instruction for use
Contents
1. This guide describes the correct set up and use of Adept Medical s STARBoard a system that facilitates trans radial catheterisation procedures The components that make up the System are The Board the Support Left Arm Support and the Table The system provides support and optimal posi tioning of the patients right or left arm depending on which arm is being used for access during trans radial angiography and revascularisation procedures These procedures are carried out by Interventional Cardiologists or Interventional Radiologists The Left Arm Support is used only for left arm pro cedures It clips onto the STARBoard after radial artery access has been achieved and supports the upper left arm presenting the wrist in an ele vated position across the abdomen of the patient which allows the clinician to continue working comfortably from the right side of the table The STARTable provides a stable work surface and support for catheters wires and other equip ment as well as additional x ray scatter reduction For more information please turn to Page 8 or visit www adeptmedical co nz pages starsystem MEDICAL System Instruction for use STARBoard STARSupport and STARTable for Trans radial Angiography and Revascularisation procedures StarBoard and StarTable for right arm support StarBoard for right arm support StarTable StarBoard set up for left arm support with clipped on STARSupport STARSys2. If the patient is restless or uncooperative secure the forearm by taping it to the forearm support on the STARBoard as illustrated in Figure 11a 11 Rotate the handle as shown in Figure 11a so the patients palm is facing upwards Figure 11b At this point it is very easy to test that the hand and wrist are in a suitable position for comfortable hyperextension or adjust if required 12 Paint the skin with antiseptic solution and drape the patient as per clinical protocol Figure 13 13 Complete other patient preparation as per hospital clinic protocol 1 Positioning for Vascular Access 14 With the palm still facing up the arm should be positioned comfortably and slightly rotated away from the patient s body Figures 12 and 14 15 Hyperextend the wrist by pivoting the hand grip downwards as illustrated in Figure 15b This can be done before or after draping For clarity this is shown here without the drape 16 Locate the radial artery and infiltrate the subcutaneous tissue with local anaesthetic 17 Access the radial artery and position the vascular sheath as per hospital clinic protocol Figure 15c Figure 11a Figure 11b Figure 14 Figure 15a Figure 15b N Figure 15c STARSystem Support for Trans radial Angiography and Revascularisation Positioning for Angiography Intervention 18 Once access is gained and the sheath is in place flex the wrist to retract the hyperexte
3. moved with the drape and positioned across the patients lower abdomen Examples of this position are shown without the drape for clarity in Figures 22 and 23 28 Rotate the STARBoard arm so it sits in against the patient s side and advance the slide fully in a caudal direction as illustrated in Figure 24 29 Install the STARSupport into the slot on the main arm of the STARBoard as shown in Figure 24 Make sure the knob is towards the head of the patient The STARSupport should click firmly into place The graphic on the blue soft touch arm support indicates its correct orientation The arrow should point towards the patient as shown below Soft touch arm support with indication of orientation Figure 22 Figure 23 Quick release knob and clamp for easy adjustment Easy install clip feature Squeeze together with fingers to remove from STARBoard Figure 24 MEDICAL KAJ STARSystem STARSystem Support for Trans radial Angiography and Revascularisation The STARSupport for Left Arm Procedures 30 Once installed the STARSupport should be adjusted to suit the patient and achieve the de sired procedural position Loosen the knob if it is not already and adjust the angle and length as illustrated in Figure 26 The blue soft touch arm support should cup the arm just above the elbow 31 The patient s elbow should be elevated as high as is comfortable so that the forearm is ap proximately horizontal when the
4. he shelf so that the arrow is approximately in line with the patient s knee The arrow should be on the lower section pointing towards the patient as illustrated in Figure 8a Slide the lower section of the shelf between the mattress and the x ray table until it comes to rest against the vertical face Figures 8b and 9a The weight of the patient on the mattress will support the shelf The vertical wall will sit between the patients arm and the x ray table as shown in Figure 10 The overhanging portion of the vertical wall al lows for the STARTable to be positioned as far towards the patient s feet and possibly over the controls as is necessary Figure 8a Figure 8b 6 Attach the shelf to the STARTable by locating the slot features over the blue coloured spigots on the vertical wall and slide down until the shelf comes to rest Figures 8b 9b and 9c 7 At this point the STARBoard can be installed if it has not been already Note The STARTable can be installed prior to the STARBoard if desired 8 Once the patients arm and wrist is positioned in the STARBoard as desired the shelf can be adjusted as necessary by sliding it along the blue spigots as illustrated in Figure 9c 9 Note The drapes will eventually cover the STARTable The shelf can still be adjusted be neath the drape as required MEDICAL Es TARsystem STARSystem Support for Trans radial Angiography and Revascularisation 10
5. nsion Figure 16a 19 Medially rotate the wrist approximately 60 degrees so that the thumb is facing up with the palm towards the patient Figure 16b and 16c 20 Leaving the hand and wrist in this position rotate the arm back towards the patient so that the forearm is now adjacent to the patient s side Figures 17 and 18 21 The rest of the procedure can now be per formed as per hospital clinic protocol 22 At the end of the procedure rotate the pa tients hand so that inner aspect of the wrist is facing up and remove the drapes 23 Remove patients hand from the hand grip 24 Remove the sheath as per hospital clinic protocol and apply radial artery occlusion band The STARBoard and shelf can now be removed Figure 16a w Figure 16b Figure 16c MEDICAL Q STARSystem Figure 17 MEDICAL Js TARsystem STARSystem Support for Trans radial Angiography and Revascularisation The STARSupport for Left Arm Procedures Figure 21 25 For left arm procedures the STARBoard is set up in the same way as for right arm procedures Follow steps 1 4 and 10 20 from the left hand side Figure 21 26 Once access to the left radial artery has been gained and the sheath is in place the patients hand can be released from the STAR Board handgrip 27 Gather the drape around the wrist and forearm while lifting the arm out of the forearm support The patient s arm is then
6. sey with the STARSystem as it may cause damage to some components over prolonged use See website for approved cleaners Do not Autoclave Maintenance Periodically the joints shown in the image below may require tightening to maintain optimal performance of the friction joints Figure 33 Ideally these should be loose enough to move when reasonable force is applied but tight enough to hold their position The tools required For the main joint to the board 18mm Hex Socket For all other joints M10 Allen Key Warnings Hypersensitivity Ensure patient has no allergic reactions to Epoxy Resin Be careful not to entrap fingers Manufacturer Adept Medical Ltd 2 6 McDonald St Morningside Auckland 1024 New Zealand PO Box 10075 Dominion Rd Auckland 1446 New Zealand www adeptmedical co nz EC Representative Hallmark IMC No 9 Meadow Garth Tadcaster LS24 8LY United Kingdom SGS United Kingdom Limited SGS House 217 221 London Rd Camberley GU15 3EY United Kingdom mam E gt Figure 31 Figure 33 Ra Scatter Test with standard shielding Scatter reduction by using the STARTable DOSE RATE Q nGy min Waist height 47 2 Reduction Neck height 80 3 Reduction View the full test details at www adeptmedical com STARSystem User Manual Issue Date July 2015 Further information on www adeptmedical com
7. tem Support for Trans radial Angiography and Revascularisation Before use Ensure that the product is clean and that it is not damaged Check all 4 of the Starboards pivoting joints Figure 1 They should pivot with the application of reasonable force They should not be loose If any of these joints are found to be loose please refer to the mainte nance section of this guide on page 8 Using the STARBoard to access the left or right radial artery positioning the STARBoard 1 With the patient lying on the table align the centre of the dagger board just below the shoul der joint as illustrated in Figure 2 While slightly lifting the patient slide the dagger board between the mattress and the x ray table until only the pivot is visible The weight of the patient on the mattress will support the STAR Board See Figures 2 3 and 4 2 Place the patients arm into the forearm support while adjusting to suit arm length as described in Figure 5 3 Add some absorbent padding under the arm if desired 4 Have the patient grip the handle in the ver tical position as shown in Figure 6 and adjust the pivots so that the patients arm is relaxed and supported Figure 7 Figure 1 Figure 2 Figure 5 K Figure 3 MEDICAL KAJ STARSystem Figure 4 MEDICAL KEJ STARSystem STARSystem Support for Trans radial Angiography and Revascularisation 5 Placement of the STARTable Align t
8. wrist is resting on the lower abdomen This prevents the arm straightening out or slipping back to the left side Once the desired position is achieved tighten the knob firmly to fix the location If desired another drape can now be placed across the sterile field around the left shoulder area The clinician can now return to right hand side of the patient to perform the angiography or inter ventional procedure 32 At the completion of the procedure loosen the knob to release the patients arm from the STARSupport Once the patients arm is clear re tighten the knob to secure the adjustable section of the STARSupport 33 To release the STARSupport from the slot in the STARBoard squeeze the clip feature to gether as indicated in Figure 29 while lifting the STARSupport out of the slot This can be done before or after the STARBoard is removed from the table Figure 29 Figure 25 Figure 26 Figure 28 Figure 30 MEDICAL Es TARsystem STARSystem Support for Trans radial Angiography and Revascularisation Cleaning The STARBoard STARSupport and STARTable can be cleaned as per your standard hospital clinical protocol for similar apparatus It should be sprayed and or wiped down with a suitable cleaning agent If desired the STARBoard can be placed inside a clean plastic bag during proce dures to help protect it further Figures 31 amp 32 Do not use Disinfectant Cleaner Virex Tb by Di ver
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