New Zealand is a small country with a big legacy in innovation. “Kiwis” have played important roles in splitting the atom, discovering DNA, building the NASA space program and being first to climb Mount Everest. They also punch above their weight in cardiology with leaders such as John Ormiston, Harvey White and Gerry Wilkins representing the country of 4 million people on international conference expert panels.
So, as you can imagine, when given the chance to review a cath lab device created by a New Zealand cardiologist, I jumped at the chance.
The Star Board is a radial arm board produced in New Zealand and designed by a leading interventional cardiologist (Mark Webster). Although an arm board is unlikely to be an enormous advance for all mankind (and would be terrible at climbing mountains), it did seem to be a different approach to a common radial problem: “Okay, sheath in, catheter in, but can someone please keep this arm from rolling around?” Don’t get me wrong, our system worked, but was far from perfect, and other products out there were variations on what we were already doing.
Like many of the cath labs in New Zealand, we perform >85% of all cases radially. Radial access benefits are well established. Now it is time to finally sort out those little issues, such as the arm that keeps moving, the board that is too big, the pool of blood that collects, the dangling Tuohey, and wires and balloons that weigh down the guide catheter.
The Star Board is currently being used in several New Zealand cath labs. I viewed it and thought the design innovative; however, as they say, the proof is in the pudding, so I wanted to try one out and post a review.
We were loaned a Star Board with no restrictions and with the purpose of a product review. I devised a survey for the team (see opposite page). Our 6 cardiologists had regular usage for 2 months. After 2 months, the cardiologists and 4 senior nurses were asked to complete a survey. We also routinely asked patients how the board felt to them as well.
I found the Star Board to be an excellent adjunct to caths and percutaneous coronary intervention. A major advantage is that it raises the arm upward, so you are working from a groin height. The ease of adjustment means that any arm can be quickly accommodated and the cradle is very supportive, prohibiting any sideways arm movement and remaining comfortable. You can use a towel or support pad for patient comfort (the company offers the Star Pad). It is easily changeable to the next patient with a completely wipeable surface. The fact that the patient has no restraint or confinement is very appealing to all. It appears durable, being made of carbon fiber, and our cath lab team has yet to break or chip it (which means it is about as tough as something can get). It has had two falls from high shelving (don’t tell the company) without incident.
The included shelf has eliminated the drag-down effect of the weight on the end of the guide and serves as a great base for interventional gear.
We perform most of our right heart caths via the basilic vein and have found the Star Board very useful. The nurses also used it extensively for PICC line insertion as well as ultrasound intravenous insertions. The nurses were unanimous in their satisfaction with the Star Board in this role. It was a great leap over any plain arm board and definitely improved performance and success. The arm stability, raising the arm up and away from the patient, and ability to easily adduct/abduct made the procedures much easier to perform.
Nothing is perfect, as they say. We found the handle could be a little cumbersome to get the patient hand into, but once we learned to slide the armrest back to allow hand hold, the problem was solved. Most of our cases were right radial access. For left radial access by shorter operators, the Star Board still works well, but needs support to bring it up high enough to meet the left groin level (try putting it under the patient alone instead of under the mattress to gain height). The Star Board is considered a long-life product and commands the price of something built that way. The price is enough to cause pause; however, all the cardiologists agreed it was worth the cost. If your way works well, then you may find no need to spend this kind of money (please share your radial preps with Cath Lab Digest).
Survey questions (above right) were asked and each answered with a grade. The survey was given to all 6 invasive cardiologists and 4 senior nursing staff.
If you are new to radials or funding a new lab, I would suggest you start with a solid foundation to your practice. With that in mind, the Star Board has taken innovation and turned it into effectiveness.
Disclosure: Jason Money, RN, RCIS, reports no conflicts of interest regarding the content herein.
Questions about the review? Jason Money can be contacted at email@example.com.
The STAR Board is available for sale in the United States. To contact Adept Medical about the Starboard directly, email firstname.lastname@example.org.
For product demonstration, view:
Adept STAR Board Youtube video: search Adept STAR Board radial armboard
For more information, visit the STAR Board company website.