Support and support system for a medical procedure

Abstract

A support for supporting an arm during a medical procedure, the support comprising an arm portion, one or more wall portions and a table portion that are connected together, wherein: the arm portion is adapted to receive an arm of a patient such that the arm extends substantially in a proximal-distal direction of the support; the one or more wall portions extend upwardly from the arm portion, wherein at least one of the one or more wall portions is adapted to limit movement of the arm substantially in a lateral direction of the support; and the table portion is elevated relative to the arm portion and at least a lateral part of the table portion extends laterally of the one or more wall portions.

Description

Support and support system for a medical procedureCross reference to related applications

[0001] The present application claims priority to Australian patent application no. 2023258392, filed 1 November 2023, the entire contents of which is incorporated herein by reference.Technical Field

[0002] The present disclosure relates to a support and support system for a limb such as an arm during a medical procedure. The disclosure also relates to a method of manufacturing the support and support system, and of using the support and support system in a medical procedure.Background

[0003] Providing support for a limb such as an arm is an important aspect of many medical procedures, to meet the needs of both patients and medical professionals.

[0004] Supports are used, for example, in catheterisation laboratories, also known as cath labs. Cardiac catheterisation is used to perform a number of procedures, including angioplasty and angiography, with a catheter being inserted into the radial artery of the forearm, often the radial artery of the right forearm. The patient will typically remain awake during the procedure.

[0005] Any discussion of documents, acts, materials, devices, articles or the like which has been included in the present specification is not to be taken as an admission that any or all of these matters form part of the prior art base or were common general knowledge in the field relevant to the present disclosure as it existed before the priority date of each of the appended claims.Summary

[0006] In an aspect of the present disclosure, there is provided a support for supporting an arm of a patient during a medical procedure, the support comprising an arm portion, one or more wall portions and a table portion that are connected together, wherein: the arm portion is adapted to receive an arm of a patient such that the arm extends substantially in a proximal-distal direction of the support; the one or more wall portions extend upwardly from the arm portion, wherein at least one of the one or more wall portions is adapted to limit movement of the arm substantially in a lateral direction of the support; and the table portion is elevated relative to the arm portion.

[0007] In another aspect of the present disclosure, there is provided a support for supporting an arm during a medical procedure, the support comprising an arm portion, one or more wall portions and a table portion that are connected together, wherein: the arm portion is adapted to receive an arm of a patient such that the arm extends substantially in a proximal -distal direction of thesupport; the one or more wall portions extend upwardly from the arm portion, wherein at least one of the one or more wall portions is adapted to limit movement of the arm substantially in a lateral direction of the support; and the table portion is elevated relative to the arm portion and at least a lateral part of the table portion extends laterally of the one or more wall portions.

[0008] In another aspect of the present disclosure, there is provided a method of performing a radial artery procedure using the support described herein, the method comprising: positioning a patient arm such that the patient arm is received by the arm portion and such that lateral movement of the patient arm is restricted by the one or more wall portions; placing a radial artery access sheath in a radial artery of the patient arm; positioning an end of a guide catheter or wire in the radial artery access sheath; and placing a portion of the guide catheter or wire on the table portion.

[0009] In another aspect of the present disclosure, there is provided a method of performing a radial artery procedure using the support described herein, the method comprising: positioning a patient arm such that the patient arm is received by the arm portion and such that lateral movement of the patient arm is restricted by the one or more wall portions; performing a radial artery procedure.

[0010] In a further aspect of the present disclosure, there is provided a method of manufacturing a support according to the preceding aspect, the method comprising: providing a polymeric sheet for forming the arm portion, one or more wall portions and / or table portion; and bending the sheet so that the one or more wall portions are formed extending upwardly from the arm portion, and / or bending the sheet so that the table portion is formed elevated relative to the arm portion.

[0011] In a yet a further aspect of the present disclosure, there is provided a support system, the support system comprising: a support for supporting an arm of a patient during a medical procedure as described herein; and an ancillary table comprising: a stabilisation portion; one or more upright portions that extend upwardly from the stabilisation portion, and an ancillary table portion that extends from the one or more upright portions.

[0012] Throughout this specification the word "comprise", or variations such as "comprises" or "comprising", will be understood to imply the inclusion of a stated element, integer or step, or group of elements, integers or steps, but not the exclusion of any other element, integer or step, or group of elements, integers or steps.Brief Description of Drawings

[0013] Embodiments of the present disclosure will now be described by way of example only with reference to the accompanying drawings in which:

[0014] Figure 1 shows a top view of a support according to an embodiment of the present disclosure;

[0015] Figure 2 shows a left rear perspective view of a support according to an embodiment of the present disclosure;

[0016] Figure 3 shows a right side view of a support according to an embodiment of the present disclosure;

[0017] Figure 4A shows a top left perspective view of a support according to an embodiment of the present disclosure;

[0018] Figure 4B shows a top right perspective view of the support shown in Figure 4A;

[0019] Figure 4C shows a bottom right perspective view of the support shown in Figure 4A;

[0020] Figure 4D shows a bottom left perspective view of the support shown in Figure 4A;

[0021] Figure 4E shows a top view of the support shown in Figure 4A;

[0022] Figure 4F shows a bottom view of the support shown in Figure 4A;

[0023] Figure 4G shows a left side view of the support shown in Figure 4A;

[0024] Figure 4H shows a right side view of the support shown in Figure 4A;

[0025] Figure 41 shows a front view of the support shown in Figure 4A;

[0026] Figure 4J shows a rear view of the support shown in Figure 4A;

[0027] Figure 5 shows an environmental view of a support according to an embodiment of the present disclosure;

[0028] Figure 6A shows a top left perspective view of an embodiment of an ancillary table according to the present disclosure;

[0029] Figure 6B shows a top right perspective view of the ancillary table shown in Figure 6A;

[0030] Figure 6C shows a bottom right perspective view of the ancillary table shown in Figure6A;

[0031] Figure 6D shows a bottom left perspective view of the ancillary table shown in Figure 6A;

[0032] Figure 6E shows a top view of the ancillary table shown in Figure 6A;

[0033] Figure 6F shows a bottom view of the ancillary table shown in Figure 6A;

[0034] Figure 6G shows a left side view of the ancillary table shown in Figure 6A;

[0035] Figure 6H shows a right side view of the ancillary table shown in Figure 6A;

[0036] Figure 61 shows a front view of the ancillary table shown in Figure 6A;

[0037] Figure 6J shows a rear view of the ancillary table shown in Figure 6A;

[0038] Figure 7 shows an environmental view of a support system according to an embodiment of the present disclosure including a support of the present disclosure and an ancillary table of the present disclosure.

[0039] While the figures herein illustrate some embodiments of the support, ancillary table or support system of the present disclosure, it will be understood that alternative embodiments are provided herein.Description of Embodiments

[0040] Some embodiments of the present disclosure relate to a support for supporting an arm during a medical procedure.

[0041] In one embodiment, with reference to Figure 1, a support 10 is provided for supporting an arm during a medical procedure. The support 10 comprises an arm portion 20 adapted to receive an arm of a patient. The arm may be received by the arm portion 20 such that the arm extends substantially in a proximal-distal direction of the support 10. The proximal -distal direction is generally indicated by arrow A in Fig. 1 and extends between a proximal end 11 and a distal end 12 of the support 10. One or more wall portions 30 extend upwardly from the arm portion 20. At least one of the one or more wall portions 30 is adapted to limit movement of a patient’s limb in a lateral direction when received by arm portion 20. A lateral-medial direction of the support 10 is generally indicated by arrow B in Fig. 1 and extends between a lateral edge 13 and a medial edge 14 of the support 10. The lateral-medial direction B is substantially perpendicular to the proximal- distal direction A. The support also comprises a table portion 40 that is in an elevated position relative to the arm portion 20, as shown, for example, in Figure 2.

[0042] The support 10 may be used to support an arm during and / or after a radial artery procedure such as a radial artery access procedure, a radial angiogram procedure or a radial angioplasty procedure, for example, as discussed in more detail below.

[0043] The table portion 40 may extend from one or more of the one or more wall portions 30, e.g. by being integrally formed with, fastened to or adhered to one or more of the one or more wall portions 30. As shown, for example in Figure 2, the table portion 40 may extend from a top of one or more of the one or more wall portions 30D.

[0044] The position of the table portion 40 may be fixed relative to the position of the one or more wall portions 30. Additionally or alternatively, the position of the table portion 40 may be fixed relative to the arm portion 20. The fixed position of the table portion 40 may be such that the table portion 40 is not moveable relative to the one or more wall portions 30 and / or the arm portion 20 in normal use. In some embodiments of the present disclosure, for example as shown in Figure 2, by providing a table portion that is fixed relative to the one or more wall portions 30 and / or arm portion 20, the support may be relatively easy to set up, use and / or manufacture, in comparison to an arrangement where the table portion is adjustable, separable and / or separate from these other features of the support 30. For example, the table portion 40 may be substantially pre-fixed during manufacture relative to the one or more wall portions 30 and / or arm portion 20 in an optimum position for use.

[0045] As shown for example in Figures 1 to 5, the table portion 40 may extend from only one of the one or more wall portions, e.g. by being integrally formed with, fastened or adhered thereto. In the support depicted in Fig. 1 to 5, the table portion 40 extends from the distal-most wall portion 30D. In an alternative embodiment, the table portion 40 may extend from a distal-most pair or group of wall portions 30.

[0046] As shown for example in Figure 2, the one of more wall portions 30 and the table portion 40 may be comprised in a single piece of material. The one of more wall portions 30 and the arm portion 20 may be comprised in a single piece of material. The one or more wall portions 30, the table portion 40 and the arm portion 20 may be comprised in a single piece of material. The single piece of material may be a substantially homogenous piece of material. The single piece of material may be substantially one piece, without joins or seams. The single piece of material may be bent or moulded to form the arm portion 20 and one or more wall portions 30, or to form the arm portion 20 and the table portion 40, or to form the arm portion 20, table portion 40 and one or more wall portions 30. The single piece of material may be a sheet of polymeric material that has been bent or moulded. The polymeric material may be a thermoplastic sheet such as a high density polyethylene (HDPE) sheet for example.

[0047] As shown for example in Figure 5, in use, at least a portion of the support 10 may be disposed directly on a support surface 62 such as a top surface of a patient table (e.g., a surgicaltable, examination table, treatment table, hospital bed, etc.). For example, at least part of the arm portion 20 of the support 10 may be disposed directly on the support surface 62. However, additionally or alternatively, at least part of the arm portion 20 may overhang the support surface, e.g. by extending laterally of a lateral edge 62a of the support surface 62.

[0048] As also shown for example in Figure 5, for comfort, the patient may be disposed on a patient mattress 60, the patient mattress 60 being located on the support surface 62. In this case, the arm portion 20 may be positioned partially underneath the patient mattress 60 or adjacent a lateral edge 64 of the patient mattress. In use, the arm portion 20 may at least partially, or entirely, extend laterally beyond the lateral edge 64 of the patient mattress 60.

[0049] Where a patient is supported on a patient mattress 60, the arm portion 20 and the one or more wall portions 30 may define, optionally in combination with a lateral edge 64 of the mattress 60, a trough into which the arm is received. As also shown for example in Figure 5, the trough may be positioned lower than the patient's torso when the patient is supported on the mattress 60. The trough may be configured to optionally receive a cushion that locates between the arm of the patient and the arm portion 20 of the support 10. The cushion may protect and cushion the underside of the patient's elbow and forearm and also elevate the patient’s arm to be more level with the patient’s torso and shoulder, further adding to patient comfort during the procedure and presenting the radial artery of the patient arm for access.

[0050] The arm portion 20 may be sized so as to provide a one-size-fits-all support 10. Whether one-size-fits-all or otherwise, the length LI of the arm portion 20 in the proximal -distal direction of the support, as shown for example in Fig. 4C, may be about 500mm to 1000mm, or 600mm to 800mm, for example. The width W1 of the arm portion 20 in a medial-lateral direction of the support, as shown for example in Fig. 4E, may be such that an average adult arm can be accommodated thereon. In some examples, the width W1 of the arm portion 20 may be about 70mm to 300mm, or 100mm to 200mm. When the support 10 is in use with a patient support mattress 60, the arm portion 20 may be placed such that the one or more wall portions 30 and the lateral edge 64 of the mattress 60 and / or patient’s torso provide a firm fit for the patient’s arm so as to minimise lateral movement of the arm and hand during a procedure.

[0051] As shown for example in Figure 5, the arm portion 20 may be positioned such that a patient’s elbow, forearm and hand are received by the arm portion 20 and a portion of the patient’s hand is received underneath the table portion 40. While not shown in Figure 5, further arm and / or hand cushioning can be placed between the patient and arm portion 20 for additional patient comfort, and also to elevate the patient’s hand towards the level of the table portion 40. This maypresent the radial artery of the patient arm for catheter access and may mean that any tubes and cables can be more readily placed over table portion 40.

[0052] The support 10 may further comprise a stabilisation portion 50 connected to the arm portion 20. The stabilisation portion may substantially secure the support 10 in position during use, e.g. relative to a support surface such as a top surface of a patient table.

[0053] As shown for example in Figures 1 to 4J, the stabilisation portion 50 may comprise a panel (e.g. a substantially flat board) on to which the patient’s body is placed directly or indirectly. For example, a patient mattress 60 may be located on top of the stabilisation portion 50 and the weight of the mattress 60, e.g. in combination with the weight of the patient’s body, may help retain the stabilisation portion 50 in position relative to the support surface. As an alternative or in addition to the panel, the stabilisation portion 50 may comprise, for example, one or more straps or other locking mechanism to secure the support 10 in position during use, e.g. by connecting to the support surface.

[0054] As shown in Figures 1 to 4J , the stabilisation portion 50 and the arm portion 20 may be comprised in a single piece of material. The stabilisation portion 50 and arm portion 20 may be provided by different regions of a panel of the support 10. The stabilisation portion 50, the arm portion 20 and the one of more wall portions 30 may be comprised in a single piece of material. As shown in Figure 2, the stabilisation portion 50, the arm portion 20, the one or more wall portions 30 and the table portion 40 may be comprised in a single piece of material. The single piece of material may be a substantially homogenous piece of material. The single piece of material may be substantially one piece, without joins or seams. The single piece of material may be bent or moulded to form the stabilisation portion 50, the arm portion 20 and the table portion 30, or to form the stabilisation portion 50, the arm portion 20, the table portion 30 and one or more wall portions 40. The single piece of material may be a sheet of polymeric material that has been bent or moulded. The polymeric material may be a thermoplastic such as a high density polyethylene (HDPE), for example.

[0055] The stabilisation portion 50, e.g. when provided as a panel, may be sized to receive all or part of a patient torso, e.g., directly or indirectly thereon. For example, the stabilisation portion 50 may have a width W2 in the medial-lateral direction of the support, as shown for example in Fig 4E, of about 100mm to 600mm, 300mm to 500mm, or 200mm to 400mm and may have a length L2, as shown for example in Fig. 4D, of about 500mm to 1000mm, or 600mm to 800mm. In some embodiments, a length L2 of stabilisation portion 50 may be the same as a length LI ofarm portion 20, as shown for example in Figures 4C and 4D. In some alternative embodiments, the length L2 of stabilisation portion 50 may differ from the length LI of arm portion 20.

[0056] The arm portion 20 may comprise one or more apertures. Apertures may be located such that they create a handle portion or such that they facilitate connection to a stabilisation portion. For example, although not shown, a locking feature could be placed through one or more apertures, or straps could be threaded through apertures which straps are used to secure the support 10 during a procedure. Apertures may also be located in the arm portion 20 so as to assist with air flow and / or patient temperature management. The stabilisation portion 50 may also comprise one or more apertures to assist with air flow and / or patient temperature management or otherwise. Apertures in the stabilisation portion 50 may be located such that they create a handle portion.

[0057] The arm portion 20 may further comprise one or more grip elements. Similarly, the stabilisation portion 50 may comprise one or more grip elements. The grip elements may help prevent movement of the support 10 when in use. One or more grip elements may be disposed on a bottom surface of the arm portion 20 and / or the stabilisation portion 50. The grip elements may comprise, for example, a section of textured surface, a semi adhesive layer or rubber attachment. In other embodiments, the arm portion 20 and / or the stabilisation portion 50 may comprise a low surface energy (LSE) material such that the low friction aids contributes to ease of positioning.

[0058] The arm portion 20 may further comprise an antibacterial material and / or antimicrobial coating. Similarly, the stabilisation portion 50 may further comprise an antibacterial material and / or antimicrobial coating. As shown in Figure 2, the arm portion 20 and / or the stabilisation portion 50 may be provided with bevelled or rounded edges to assist with preventing damage to medical equipment and / or assist with preventing injury to the patient or medical staff.

[0059] As discussed, the support 10 comprises one or more wall portions 30 which extend upwardly from the arm portion 20. As shown for example in Figure 5, one or more of the one or more wall portions 30 are adapted to limit lateral movement of a patient arm when received by the arm portion 20.

[0060] As shown for example in Figure 1, in some embodiments the one or more wall portions 30 extend upwardly in a direction substantially perpendicular to a planar surface of the arm portion 20. In these or other embodiments one or more of the one or more wall portions 30 may be partially, or substantially, curved, e.g., towards the medial direction of the support 10, to cradle a patient arm when received by the arm portion 20. In these or other embodiments one or more ofthe one or more wall portions 30 may extend upwardly from the arm portion at an obtuse angle to assist with guiding the patient arm onto arm portion 20.

[0061] As shown for example in Figure 2, the one or more wall portions 30 may comprise bevelled or rounded edges to assist with preventing damage to medical equipment and / or assist with preventing injury to the patient or medical staff. One or more wall portions 30 may comprise an antibacterial material and / or antimicrobial coating 36.

[0062] The one or more wall portions 30 may be sized to effectively limit movement of the arm substantially in a lateral direction of the support. For example, the one or more wall portions 30 may have a height Hl of about 50mm to 200mm, or 80mm to 170mm. The height Hl of the one or more wall portions 30 may be substantially similar among the one or more wall portions 30. In some alternative embodiments, a height H2 of a wall portion 30 may differ from the height Hl of a different wall portion 30. For example, as shown in Figure 3, the support may comprise one or more wall portions 30A, 30B having a height Hl of about 130mm, and a wall portion 30C having a height H2 of about 85mm.

[0063] The one or more wall portions 30 may have a length L3 in the proximal-distal direction of the support, as shown for example in Fig. 4H, of about 100mm to 500mm, or 150mm to 250mm. The length L3 of the one or more wall portions 30 may be substantially similar among the one or more wall portions 30. In some alternative embodiments, a length L4 of one or more wall portions 30 may differ from the length L3 a different wall portion 30. For example, the support may comprise one or more wall portions 30 having a length L3 of about 150mm, and a wall portion 30D having a length L4 of about 250mm. In some embodiments the support 10 may comprise a wall portion 30 that is two to four times the length of another wall portion 30. In some embodiments, the wall portion 30D from which the table portion 40 extends may have a length in the proximal -distal direction of the support that is greater than one or more of the other wall portions 30.

[0064] As indicated, the table portion 40 may be integrally formed with one or more of the one or more wall portions 30. For example, as shown in Figures 2 and 3, the table portion 40 may be formed by folding an extension of one or more of the one or more wall portions medially such that table portion 40 is in an elevated position relative to the arm portion 20. In other embodiments, table portion 40 may be fixedly or removably connected to one or more of the one or more wall portions 30 by other means.

[0065] In the embodiments shown in Figures 1 and 2, four wall portions 30A - 30D are provided at or near the lateral edge 13 of support 10 and a table portion 40 extends from one of thefour wall portions 30D. In these embodiments the table portion 40 is integrally formed with wall portion 30D. In alternative embodiments, although not shown, the table portion 40 can extend from more than one of the wall portions, for example from two wall portions 30C, 30D, to increase stability and / or accommodate a larger table work surface.

[0066] In embodiments where more than one wall portion is provided, the wall portions 30 may be sized and disposed such that the one or more wall portions are separated by gaps. The gaps may provide access to a patient’s arm when received by the arm portion 20, and may contribute to patient comfort. Additionally or alternatively, the gaps may provide a means of reducing the amount of material required to form the support 10, which may decrease the weight of the support 10. Additionally or alternatively, the gaps may provide a means of handling and positioning.

[0067] In the embodiment shown in Figure 3, three wall portions 30A to 30C are provided such that the wall portions 30A, 30B and 30C are separated by gaps generally indicated by arrows DI and D2. The wall portions 30A, 30B and 30C may be disposed such that a distance DI of the gap between the wall portions is constant or varies. For example, a distance DI of the gap between the first wall portion 30A and the second wall portion 30B may be between about 25mm to 75mm or about 50mm. As shown in Figure 3, a longer gap, a distance D2, of between about 100mm and 200mm or about 150mm, may be provided between the second wall portion 30B and the third wall portion 30C. The table portion 40 may extend from the third wall portion and the gap having distance D2 may allow for ease of access to the patient wrist. In the example of Figure 3, the table portion 40 is integrally formed with the third wall portion 30C and the table portion 40 has been formed by bending material medially at a height below the height of the other wall portions 30A and 30B, thus bringing the table portion further into alignment with the patient wrist when disposed on the support 10.

[0068] As shown for example in Figures 4A to 5, the table portion 40 may fixedly or removably extend from one or more of the one or wall portions. For increased stability, the wall portion 30 may connect to the table 40 portion at a position inwards of (medially of) the lateral- most edge of the table portion 40.

[0069] In some embodiments, for example, as shown in Figures 4G and 4H, the length L5 of a top section of a wall portion 30D may be longer than the length L4 of a bottom section of a wall portion 30D.

[0070] The table portion 40 may be in an elevated position relative to the arm portion 20, with or without being directly above arm portion 20. The table portion 40 may not be disposed directly above the arm portion 20, for example, where the table portion 40 extends from one or more wallportions 30 in a direction away from the arm portion 20, for example in a lateral and / or distal direction.

[0071] The elevated position of the table portion 40 relative to the arm portion 20 is preferably such that table portion 40 is elevated relative to a patient arm disposed on the arm support portion 20. The elevated position of table portion 40 relative to the arm portion 20 may be the same as the height Hl, H2 of the one or more of the wall portions 30.

[0072] As shown for example in Fig. 41, the table portion 40 may comprise a top surface 41 adapted to receive medical equipment and / or provide a work surface. Additionally, the table portion 40 may support, and therefore decrease the sagging, twisting or bending of, drapes, cables, tubes and other medical equipment required for the medical procedure.

[0073] As shown for example in Figure 2, the table portion 40 may comprise bevelled or rounded edges to assist with preventing damage to medical equipment and / or assist with preventing injury to the patient or medical staff. The table portion 40, including the top surface 41, may also comprise an antibacterial material and / or antimicrobial coating 46.

[0074] In some embodiments, the table portion 40 further comprises one or more rails extending upwardly from the top surface 41. Although not shown in the Figures, the one or more rails of the table portion 40 may be similar to a rail 93 of an ancillary table portion 90 as discussed further below. The one or more rails may be adapted to limit movement of medical equipment disposed on the top surface of the table portion 40. In some embodiments the one or more rails may be disposed at or near a lateral edge of the top surface 41 to prevent lateral movement of medical equipment disposed on the table portion 40.

[0075] The table portion 40 may further comprise a recess or channel such as gutter 45 disposed in the top surface 41, which may be adapted to receive medical equipment, such as cables or tubes, and / or assist with drainage, for example.

[0076] As shown for example in Figures 41 and 4J, to increase the stability of the table portion 40, one or more stabilisation members 47 may be provided, such as one or more brackets, aprons or stretchers. Additionally, the table portion 40 may comprise a handle portion. Although not shown, in some embodiments the handle portion may extend from the table portion 40 or may be formed via an aperture disposed in the table portion 40. Although not shown, the table portion 40 may also comprise one or more storage elements, such as shelves or draws.

[0077] In some embodiments, the table portion 40 may include an extension region 44 that extends distally of a distal end 12 of the arm portion 20 of the support 10.

[0078] In some embodiments, a length L6 of the table portion 40 of the support, shown for example in Fig. 4H, may be between about 150mm and 600mm, between about 200mm and 500mm, or between about 300mm to 350mm. A thickness of the table portion 40 may be adapted to support the weight of medical equipment.

[0079] In some embodiments the width W3 of the table portion 40 may be consistent along the length of the table portion 40, as shown for example in Fig. 4E. In other embodiments, such as shown in Figure 2, a width W3 of the table portion 40 may vary along the length of the table portion 40. The width W3 of the table portion 40 may be between about 100mm and 400mm, between about 125mm and 175mm, or about 150mm, for example.

[0080] In some embodiments, as shown for example in Figures 4A to 4J, at least a medial part 40a of the table portion 40 may extend medially relative to the one or more wall portions 30 and / or relative to a lateral edge of the arm portion 20. In some embodiments, such as shown in Figure 1, the table portion 40 may extend entirely medially from one or more of the one or more wall portions 30 and / or a lateral edge of the arm portion 20. In other embodiments, at least a lateral part 40b of the table portion 40 may extend laterally relative to the one or more wall portions 30 and / or relative to a lateral edge of the arm portion 20, for example as shown in Figs. 41 and 4J. Providing a lateral part 40b of the table portion 40 may provide significant benefits by providing for an increased size of the table portion 40, by enabling the table portion 40 to support items in closer vicinity to medical staff, and / or by providing for a more structurally balanced positioning of the table portion 40 on the one or more wall portions 30, reducing the risk of the table portion breaking from the one or more wall portions while supporting heavy objects.

[0081] The length L6 direction of the table portion 40 may be aligned with the length LI direction of the arm portion 20 in some embodiments, or else may be at a different angle. For example, the different angle may be such that a direction of elongation of the table portion 40 is not only in a distal direction from the arm portion 20 but in a slight lateral direction from the arm portion 20, as may be evident in Figures 4E and 4F, for example.

[0082] During use of the support 10, a patient arm is positioned such that the patient arm is received by the arm portion 20 and such that lateral movement of the patient arm is restricted by the one or more wall portions 30.

[0083] Medical procedure staff may position the support 10 on a patient table. Optionally, as shown for example in Fig. 5, a patient support mattress 60 is then placed on top of at least the stabilisation portion 50 of the support 10. A patient is then directed to lie on the support surface 62 such as a patient table or on the mattress 60 on top of the support surface 62, such that their armsits next to their body and is received by the arm portion 20 of the support 10. The patent’s arm may rest on the arm portion 20 between a lateral edge 64 of the mattress 60 and the one or more wall portions 30 of the support 10. The support 10 may then be readjusted to decrease the gap between the patient’s arm and the one or more wall portions 30, e.g. by sliding part of the arm portion 20 under the patient / patient support mattress 60.

[0084] To begin a radial access procedure the patient’s arm, often the right arm, may be first abducted into a radial access position. The patient’s arm may be supported by a board such as an arm board while access to the radial artery is obtained, the board being removed thereafter. The arm board may be a flat board. Once access to the radial artery is obtained, the patient’s arm may be moved, e.g., adducted, to a procedural arm position by placing the arm down on the arm portion 20.

[0085] For radial artery procedures, the table portion 40 may be positioned just distal to the hand, commonly the right hand, such that in some embodiments a patient’s palm and / or fingers (e.g. only the patient’s palm and / or fingers) may extend under the table portion 40. In this position, the table portion 40 provides a flat stable surface at a height which may align with the level of a sheath placed in the right radial artery. In some procedures, such as right radial artery coronary angiography or angioplasty, a guide catheter and wires are positioned in the sheath on a horizontal plane at the height of the table portion 40 to allow traversing of the radial artery to perform the procedure. The catheter and wires may be placed over the table portion 40. The approach may ensure that low torque is placed on the equipment at the table portion 40 height which may be essential for the equipment to be effectively used.

[0086] A method of performing a radial procedure using the support 10 may comprise: positioning a patient arm such that the patient arm is received by the arm portion 20 and such that lateral movement of the patient arm is restricted by the one or more wall portions 30; placing a radial artery access sheath in a radial artery of a patient; positioning an end of a guide catheter or wire in the radial artery access sheath; and placing a portion of the guide catheter or wire on the table portion 40. In some embodiments, the placing of a radial artery access sheath and / or the positioning of an end of a guide catheter or wire in the radial artery access sheath may take place when the patient arm is received by the arm portion 20 or prior to the patient arm being received by the arm portion 20. In some embodiments, the method may comprise, when the patient arm is received by the arm portion 20, performing a radial angiogram and / or performing radial angioplasty.

[0087] In some embodiments, a method of performing a radial artery procedure using the support 10 may comprise: positioning a patient arm such that the patient arm is received by the arm portion 20 and such that lateral movement of the patient arm is restricted by the one or more wall portions 30; performing a radial artery procedure, wherein the radial artery procedure is a radial angiogram and / a radial angioplasty, for example.

[0088] In some embodiments, to form the support 10 as shown in Figures 1 and 2, a polymeric sheet, e.g. a thermoplastic sheet such as a High Density Polyethylene (HDPE) sheet, is heat bended to form the arm portion 20 and the one or more wall portions 30 and the table portion 40, generally as one integral piece. Heat may be applied to assist with bending of the sheet

[0089] For example, in one embodiment a method of manufacturing the support 10 may including providing a polymeric sheet for forming the arm portion 20, the one or more wall portions 20 and / or the table portion 30, bending the sheet so that the one or more wall portions 30 are formed extending upwardly from the arm portion 20; and / or bending the sheet so that the table portion 40 is formed elevated relative to the arm portion 20.

[0090] The sheet may be a High Density Polyethylene (HDPE) sheet. The bending may be heat bending (e.g. bending the sheet when heat has been applied to the sheet and the sheet is therefore at an elevated temperature). The polymeric sheet may be a thermoplastic sheet such as a High Density Polyethylene (HDPE) sheet. The bending of the sheet to form the one or more wall portions may including bending the sheet at about 70 to 110 degrees, e.g. about 90 degrees. A bend formed between the arm portion and the one or more wall portions may be may be a curved bend of about 20 to 40mm radius, e.g. about 30mm radius. The bending of the sheet to form the table portion may comprise bending the sheet at about 70 to 110 degrees, e.g. about 90 degrees. A bend formed between the one or more wall portions and the table portion may be a curved bend of about 20 to 40mm radius, e.g. about 30mm radius. The method of manufacturing may be such that at least the arm portion 20 and the one or more wall portions 30, and / or the arm portion 20 and the table portion 40, are of one single integral piece of material.

[0091] In other embodiments, the support 10 may be formed by molding, fastening or adhering one or more of the components of the support 10 together. Optionally the stabilisation portion 50 is extended from the arm portion 20 by being integrally formed with, molded with, or fastened or adhered thereto.

[0092] In some embodiments, as shown for example in Figure 7, a support system 200 is provided that includes the support 10 as described above and also an ancillary table 100. The ancillary table 100 may comprise a stabilisation portion 70, one or more upright portions 80, suchas walls or posts that extend upwardly from the stabilisation portion 70, and an ancillary table portion 90 that extends from the one or more upright portions 80. The support system 200 may further comprise one or more patient positioning cushions. The one or more upright portions 80 may extend upwardly in a direction that is perpendicular or at an angle relative to the stabilisation portion 70.

[0093] As shown for example in the embodiment of Figures 6A to 6J, the stabilisation portion 70 may comprise a flat panel adapted to be placed underneath a patient or patient mattress 60. For example, a patient mattress 60 may be located on top of the stabilisation portion 70 and the weight of the mattress 60, e.g. in combination with the weight of the patient’s body, may help retain the stabilisation portion 70 in position relative to a patient support surface. Where the stabilisation portion 70 comprises a flat panel the stabilisation portion may be well adapted for ease of cleaning.

[0094] As an alternative or in addition to the panel, the stabilisation portion 70 may comprise, for example, one or more straps or other locking mechanism to secure the support 10 in position during use, e.g. by connecting to the support surface. The stabilisation portion 70 may further comprise apertures for handling or additional securement. One or more grip elements and / or an antimicrobial coating may also be provided. Preferably the stabilisation portion 70 is configured for ease of cleaning. The one or more upright portions 80 may have a height H3 of between about 50mm to 200mm, or 80mm to 170mm, for example. The height H3 of the one or more upright portions 80 may be substantially similar among the one or more upright portions 80, as shown for example in Fig. 6G. In some alternative embodiments, a height H4 of an upright portion 80 may differ from the height H3 of a different upright portion 80.

[0095] The elevated position of table portion 90 relative to the stabilisation portion 70 is preferably such that table portion 90 is elevated relative to a patient who may be disposed laying on or next to stabilisation portion 70. The elevated position of table portion 90 relative to the stabilisation portion 70 may be the same as the height H3 and / or H4 of the one or more of the upright portions 80.

[0096] In some embodiments as shown for example in Figures 61 and 6J, at least a medial part 90a of the table portion 90 extends medially relative to the one or more upright portions 80 and / or a lateral edge of the stabilisation portion 70. In some cases, the table portion 90 may extend entirely medially from one or more upright portions 80 and / or a lateral edge of the stabilisation portion 70. In other cases at least a lateral part 90b of the table portion 90 may extend laterally relative to the one or more upright portions 80 and / or a lateral edge of the stabilisation portion 70,for example as shown in Figs. 61 and 6J. Providing a lateral part 90b of the table portion 90 may provide significant benefits by providing for an increased size of the table portion 90, by enabling the table portion 90 to support items in closer vicinity to medical staff, and / or by providing for a more structurally balanced positioning of the table portion 90 on the one or more upright portions 80, reducing the risk of the table portion breaking from the one or more upright portions while supporting heavy objects.

[0097] In some embodiments, for example, as shown in Fig. 6H, a length L10 of a top section of an upright portion 80 may be longer than a length L9 of a bottom section of an upright portion 80.

[0098] The one or more upright portions 80 may also comprise one or more apertures or an antimicrobial coating 36.

[0099] The ancillary table portion 90 comprises atop surface 91. As shown for example in Figures 6A to 6J, one or more rails 93 may extend upwardly from the top surface 91 to prevent movement of medical equipment off the top surface 91. One or more recesses or channels such as gutters may be disposed in the top surface 91 adapted to hold medical tubes or cables or to provide drainage.

[0100] The ancillary table portion 90 may further comprise any of: one or more apertures or table handle portion for handling; an antimicrobial coating; stabilisation elements; an ancillary table extension portion or ancillary table storage means, such as a shelf or draw.

[0101] The ancillary table portion 90 may have a length L7, as shown for example in Fig. 6H, of between about 150mm and 600mm, between about 200mm and 500mm, or between about 300mm to 350mm. A thickness of the ancillary table portion 90 may be adapted to support the weight of medical equipment. A length L8 of the stabilisation portion 70, as shown for example in Fig. 6F, may be between about 100mm and 500mm, between about 200mm and 400mm, or between about 200mm to 250mm. The length L8 of stabilisation portion 70 may be the same as, or differ from, the length L7 of the ancillary table portion 90, as shown for example in Fig. 6F.

[0102] As shown for example in Fig. 6E, in some embodiments a width W4 of the ancillary table portion 90 is consistent along the length of the ancillary table portion 90. In other embodiments the width W4 of the table portion may vary along the length of the ancillary table portion 90. The width W4 of the ancillary table portion 90 may be between 100mm and 400mm, between 125mm and 175mm, or about 150mm, for example.

[0103] In a support system 200, the table portion 40 and ancillary table portion 90 are preferably at a height just above the arm of the patient and preferably at an efficient height relative to the sheath and guide catheter during radial artery procedures. When support system 200 is in use, the height of the ancillary table portion 90 may be the same as, or differ from, the height of table portion 40. The ancillary table portion 90 may be positioned in different orientations relative table portion 40.

[0104] The top surface 41 of the table portion 40 may align with the top surface 91 of the ancillary table portion 90. The ancillary table portion 90 may provide for an extension of the work surface created by the table portion 40.

[0105] The ancillary table portion 90 may be aligned in the same orientation as the table portion 40, for example in the proximal-distal orientation, to provide a longer platform for keeping tubes and guidewires straight during procedures. The table portion 40 and the ancillary table portion 90 may provide in combination a relatively large surface for medical equipment such as tubes and cables such that they are aligned with the length of the patient's arm. This may decrease the bending or drooping forces placed on such equipment in addition to providing a work surface for staff. While the ancillary table 100 may be disposed adjacent the support 10, alternatively, a larger distance between the ancillary table 100 and the support 10 may be preferred in order to assist in keeping cables and tubes straight over an even greater distance.

[0106] As shown in Figure 7, the table portion 40 and the ancillary table portion 90 may be placed so as not to obstruct surgical table controls. The surgical table controls may be used to control the patient table position and x-ray settings and may need to remain easily accessible by staff during a procedure.

[0107] The support system 200 may further comprise a board such as an arm board for use at the beginning of radial access procedures when the arm is abducted for initially gaining access to the radial artery. The arm board may optionally be flat and may be independent of the present support 10 or may otherwise be secured to the arm portion 20 of the support 10, for example via the stabilisation portion 50. In some embodiments, the arm board may be integrally formed with the support 10. In some embodiments, the patient arm may be removed from the arm board after a radial access procedure is completed and the patient arm may be positioned on the arm portion 20 of the support 10 for performing a radial angiogram procedure and / or radial angioplasty procedure.

[0108] The support 10 and the ancillary table 100 described herein may comprise any suitable material. Material such as carbon fiber may be selected to minimise the weight and increase thedurability of the supports. Material such as lead could be selected to provide protection from scatter radiation. High Density Polyethylene (HDPE) sheeting may be used for easy and low cost of manufacture and ease of handling. Materials and / or coatings may be selected to aid in cleaning and sterilisation and / or offer resistance to chemical attacks from disinfectants.

[0109] It will be understood that while procedures such as angioplasty and angiography are often undertaken with a catheter being inserted into the radial artery of the right forearm, the support and support system disclosed herein can be used and / or adapted for procedures involving the left forearm. While the discussion herein uses radial artery procedures as an example, it will be understood that the support and support system can be used for other types of procedures, including procedures accessing other arteries.

[0110] It will be appreciated by persons skilled in the art that numerous variations and / or modifications may be made to the above-described embodiments, without departing from the broad general scope of the present disclosure. The present embodiments are, therefore, to be considered in all respects as illustrative and not restrictive.

Claims

CLAIMS1. A support for supporting an arm during a medical procedure, the support comprising an arm portion, one or more wall portions and a table portion that are connected together, wherein: the arm portion is adapted to receive an arm of a patient such that the arm extends substantially in a proximal-distal direction of the support; the one or more wall portions extend upwardly from the arm portion, wherein at least one of the one or more wall portions is adapted to limit movement of the arm substantially in a lateral direction of the support; and the table portion is elevated relative to the arm portion and at least a lateral part of the table portion extends laterally of the one or more wall portions.

2. The support of claim 1, wherein the table portion extends from one or more of the one or more wall portions.

3. The support of claim 1 or claim 2 wherein the table portion extends from a top of one or more of the one or more wall portions.

4. The support of claim 1 or claim 2, wherein the one or more wall portions comprises a plurality of the wall portions that are distributed in the proximal -distal direction of the support.

5. The support of claim 4, wherein the plurality of wall portions are distributed along a lateral edge of the arm portion, the lateral edge extending in the proximal-distal direction of the support.

6. The support of claim 4 or 5, wherein a gap is provided between each of adjacent wall portions of the plurality of wall portions.

7. The support of claim 6, wherein the table portion extends from a distal-most wall portion of the plurality of wall portions or a distal-most pair or group of wall portions of the plurality of wall portions.

8. The support of any one of the preceding claims, wherein at least part of the table portion extends from the wall portion in a medial direction and / or distal direction.

9. The support of any one of the preceding claims, wherein at least part of the table portion extends distally relative to a distal end of the arm portion.

10. The support of any one of the preceding claims, wherein the one of more wall portions and the arm portion are comprised in a single piece of material.

11. The support of any one of the preceding claims, wherein the one of more wall portions and the table portion are comprised in a single piece of material.

12. The support of any one of the preceding claims, wherein the arm portion, the one of more wall portions and the table portion are comprised in a single piece of material.

13. The support of any one of claims 10, 11 or 12, wherein the single piece of material is a continuous, substantially homogenous piece of material without joins or seams.

14. The support of any one of claims 11 to 13, wherein the single piece of material is bent or moulded to form the arm portion and the one or more wall portions, or to form the arm portion and the table portion, or to form the arm portion, the table portion and the one or more wall portions.

15. The support of any one of the preceding claims, wherein the position of the table portion is fixed relative to the one or more wall portions.

16. The support of any one of the preceding claims, wherein the position of the table portion is fixed relative to the arm portion.

17. A method of using the support of any one of the preceding claims, the method comprising positioning a patient arm such that the patient arm is received by the arm portion and such that lateral movement of the patient arm is restricted by the one or more wall portions.

18. A method of performing a radial artery procedure using the support of any one of claims 1 to 16, the method comprising: positioning a patient arm such that the patient arm is received by the arm portion and such that lateral movement of the patient arm is restricted by the one or more wall portions; placing a radial artery access sheath in a radial artery of the patient arm; positioning an end of a guide catheter or wire in the radial artery access sheath; and placing a portion of the guide catheter or wire on the table portion.

19. A support system comprising: the support of any one of claims 1 to 16; andan ancillary table comprising: a stabilisation portion; one or more upright portions that extend upwardly from the stabilisation portion, and an ancillary table portion that extends from the one or more upright portions.

20. A support system comprising: a support comprising: an arm portion, one or more wall portions and a table portion that are connected together, wherein: the arm portion is adapted to receive an arm of a patient such that the arm extends substantially in a proximal-distal direction of the support; the one or more wall portions extend upwardly from the arm portion, wherein at least one of the one or more wall portions is adapted to limit movement of the arm substantially in a lateral direction of the support; and the table portion is elevated relative to the arm portion; and an ancillary table comprising: a stabilisation portion; one or more upright portions that extend upwardly from the stabilisation portion, and an ancillary table portion that extends from the one or more upright portions.

21. A method of manufacturing a support for supporting an arm of a patient during a medical procedure, the method comprising: providing a polymeric sheet for forming the arm portion, the one or more wall portions and / or the table portion, bending the sheet so that the one or more wall portions are formed extending upwardly from the arm portion; and / or bending the sheet so that the table portion is formed elevated relative to the arm portion.

Images