Left Radial Support Sling
Developed by a senior cardiac radiographer, the Radial Support Sling is designed to overcome various problems associated with a left radial access coronary angiography.
A coronary angiography is completed to assess the patency of the vessels which supply the heart muscle with blood. A catheter is inserted into the cardiovascular system and located in the coronary arteries feeding the heart. When the catheter is in the correct position a high attenuation contrast agent is injected into the blood vessels to enable coronary blood flow to be visualised under x-ray fluoroscopy. The comfort of the patient is an important issue as the procedure can be prolonged.
The catheter can be inserted into a femoral or radial artery. Recent evidence suggests that radial access should be used in preference to femoral access as it is less painful for the patient, recovery time is shorter and the patient is less likely to require a bed overnight.
The configuration of the angiography theatres is such that the surgeon stands to the right of the patient and the x-ray equipment and monitors are located on the left of the patient, therefore arterial access is generally gained from the right. However, in certain circumstances a left access may be required, for example when there are problems with right radial access or when the patient has undergone coronary artery bypass grafting. The positioning of the x-ray equipment and monitors prevents the surgeon from standing on the left side of the patient hence the surgeon must lean over the patient to position the catheter into the artery.
This uncomfortable position for both the patient and the surgeon does in many cases result in the surgeon using a femoral approach rather than a radial approach with the resulting increase in discomfort and time in hospital for the patient.
The Radial Sling supports the left arm in a position over the trunk. This will enable the surgeon to complete a left radial approach without leaning over the patient and prevents the arm from slipping. This provides comfort both for the patient and the operator as the alternative would be a femoral artery approach leading to a greater recovery time and potentially more complications.
The device, developed by a senior cardiac radiographer at the South Tees Hospital Trust, enables the patients left arm to be held in a comfortable position for both the patient and the surgeon whilst not impeding the imaging. The angiography sling is used to hold the left arm of the patient over the body and will be held in place by a Fixation Board that slides easily under the patient table (between the mattress and the frame).
The sling is designed to be placed around the left elbow thus maintaining the arm in a straight position and enabling the catheter to be inserted more easily into the blood vessel. The increased area of the sling around the elbow provides a comfortable hold of the arm dissipating the pressure over a large area. The straps of the sling have been kept relatively compact to reduce any impact that the sling may have on image quality.
The mechanism for fixing the sling to the bed is a simple design with Velcro loops and hooks onto which the sling is attached. The fixation board has a degree of flexibility to enable it to be fitted to a range of patient tables. The position of the board on the patient table will not impede the ability of staff to obtain good quality images.
The sling has a section of Velcro on the strap to enable it to be used with a range of patient sizes and accommodate even obese patients.