An operating room table without accessories is, well, just a flat table, one OR table expert is fond of saying. Accessories, he says, are what make the table really useful for surgery.

The products on the pages that follow illustrate some of the innovative ways you can customize your OR table to suit your case needs and staff preferences. Assessing the quality of a table attachment comes down to considering three points, say the experts we talked to:

• Patient safety. Be sure it has no sharp edges and will attach stably to your equipment.
• Ease of use. See if it is easy to adjust during a surgical procedure without risking its stability.
• Surgical efficacy. Check to find out if it will offer your surgeons the site access they need for their specialties.

At Union Hospital in Union, N.J., surgeons regularly use table attachments to perform arthroscopy, neurosurgery, shoulder surgery and laminectomies. The challenge for Cheryl Wolf, RN, MS, CNOR, CNA, administrative director of perioperative services, is to find devices that can meet the needs of these different specialties. Since Ms. Wolf doesn't have the resources to buy everyone's favorite choice, she says she usually (and she uses the term lightly) gets the physicians to come to a compromise on a particular device. "If they cannot agree, I will try to get one of the vendors to bring their device in on a per-case basis," she says. "Sometimes there's no charge, and sometimes it's on a fee-per-procedure basis."

Some facilities may find they need attachments so their tables can accommodate patients who are either too heavy or too tall for an OR table. And while most attachments can clamp on and hold steady, this is one area where different table types could be incompatible with different attachments.

Standardizing tables to general-use rooms allows the greatest versatility for these situations, says Connie Zumwalt, RN, BA, CNOR, project specialist for QRM at BroMenn Healthcare System in Bloomington, Ill. Having a few attachments nearby will help the team get through the procedure, she says.

"We allocate a basic set of attachments for each table," says Ms. Zumwalt. "We also allocate an appropriate number of additional special attachments, such as Allen stirrups, for case volume demands."

- Nathan Hall

RMV->)AADCO Medica
S-315 Handleless
Reinforced Undertable Shield
(800) 225-9014
www.aadcomed.com
Price: $2,956
FYI: This attachment has a handleless design, which means that instead of adjustment handles it has two recessed Allen Head Fasteners and an attached wrench with a protective metal bar that fastens the protective rubber shield to the framework. These features make the shield durable and less likely to be damaged by collisions with gurneys or other equipment, says AADCO. The seven-panel design also lets you position a C-arm through the shield.

Allen Medical Systems
Dura-Board Armboard
(800) 433-5774
www.allenmedical.com
Price: $349
FYI: The components of this armboard are enclosed in a durable, molded plastic body to protect them against denting and breakage. The manufacturer says it is designed for easy, no-tilt mounting, removal and repositioning. Its pull-trigger mechanism provides easy 180-degree lateral adjustment with 11 positions and the rail clamp latch prevents inadvertent detachment.

David Scott Company
21 Position Ratcheting Armboard
(508) 875-3333
www.davidscottco.com
Price: $450
FYI: This 26-inch long armboard is designed to attach easily to any standard siderail, according to the manufacturer. It has a heavy-duty casting gear assembly to keep its teeth from being broken and can be set to 21 different positions at 8.6-degree increments. Each armboard comes with a 3.25-inch combo series tri-level pad made from Blue Diamond Gel, which is designed to be re-usable, repairable and X-ray translucent.

Samanghen Corporation
Surgical Field Management System
(877) 726-2644
www.samanghen.com
Price: $950 on a rental basis with the purchase of one box of disposable components per month.
FYI: This system stabilizes tonsillectomy retractors and laryngoscopy chest supports while providing organization to the surgical field during ENT procedures, says the company. It attaches to the OR table via a C-clamp and extends laterally over the patient, replacing the unstable Mayo stand. The risk of extubation is minimized because the system supports and centers the anesthesia circuit. Because it is adjustable, it effortlessly maintains any angle for the laryngoscope hands-free and without chest pressure. The disposable holsters provide the surgeon ready access to cautery and suction handpieces and saline.'

Steris Corporation
Bariatric Power
Lift Stirrups
(800) 548-4873
www.steris.com
Price: Not disclosed
FYI: The Bariatric Power Lift Stirrups have a weight capacity of up to 780 pounds. They feature a larger boot area to accommodate heavier legs and larger pads to completely encapsulate the foot, ankle and calf for comfortable and secure positioning. The manufacturer says the stirrups' power lift system neutralizes lower extremity weight and allows effortless movement and positioning of the leg. These devices also have a quick-release handle for finite intraoperative adjustments with a gloved hand through the drape without compromising the sterile field.

Maquet Surgical Workplace Solutions from Getinge USA
Maquet MIS Hip Attachment
(800) 475-9040
www.getingeusa.com
Price: $25,000 to $35,000
FYI: The MIS Hip Attachment enhances the functionality of Maquet surgical tables by allowing better surgical access when performing minimally invasive total hip replacement, according to the manufacturer. It helps speed recovery times by enabling surgeons to make an incision of only 2 to 3 inches instead of the more common 8- to 10-inch opening. The attachment's carbon-fiber radiolucent traction bar and pelvis plate permit unobstructed imaging of the lower extremities.

Berchtold Corporation
J-Leg Extender
(800) 243-5135
www.berchtoldusa.com
Price: $901
FYI: Featuring an improved candy cane design for greater leg clearance, this device is constructed of stainless steel for smooth operation and improved reliability, says Berchtold. It has strong rotation lock to prevent drift and permits vertical adjustment from 28 inches to 41 inches. Heel straps are included, but clamps must be purchased separately, says the company.

Oakworks Medical Equipment
Carbon Fiber Arm Board
(800) 916-4612
www.oakworks.com
Price: $950
FYI: The Oakworks Carbon Fiber Arm Board is fully radiolucent and offers 180 degrees of motion. The company says it requires no mounting or attachment because it slides under the tabletop pad. It can be used on any fluoroscopy table and can support a patient's arms or feet in a variety of positions.

Handheld Digital Recorder Eliminates Tapes
Here's a sharper, smarter way for your surgeons to dictate.

Physicians who don't want to fumble with tapes in the age of electronic recordings may want to consider getting the Digital Pocket Memo 9600 from Royal Philips Electronics. The manufacturer says this device was designed to be ergonomic with its large display screen and intuitive with its three "smart buttons" similar to those on a mobile phone. It also offers voice activation and mandatory keyword commands and two levels of security: a PIN that users enter to activate the device and a personal user keyword that lets IT staff or supervisors override the lock-out mode if the PIN is lost or forgotten.

Facilities that do transcription in-house will appreciate how this handheld recorder can be placed into the optional LAN docking station so dictation can be automatically uploaded to a LAN without the need for a PC connection. These docking stations can placed in spots where users are most likely to dictate memos, notes or reports, such as outside of libraries, conference rooms or patient care areas.

The Digital Pocket Memo 9600 costs $499, which includes a leather carrying case, a docking station, rechargeable batteries, a USB cable and Speech Exec Pro software. For more information, visit www.dictation.philips.com or circle 167 on your Reader Service Card.

Record Surgery in High-Def
Your surgeons can record surgery, burn high-definition images onto a CD or DVD and present the images at seminars, workshops and courses using the Med X Change HDMD, a compact recording system designed to integrate with Leica Microsystems surgical microscopes.

The HDMD, one-third the size of other recording systems on the market, captures live video and still images from a high-definition microscope camera during surgery, digitally records the images in HD format and displays the images in HD quality on a screen. The recorded videos import directly into Microsoft PowerPoint and are ideal for presentations and training. HD images are particularly useful for situations where students cannot view surgical procedures directly through the microscope. The video collection can be integrated with patient data files using the archiving feature.

The HDMD unit seamlessly integrates with new Leica surgical microscopes. This same compact system, including a monitor, integrates just as easily with existing Leica microscopes. You can also place the HDMD on a mobile pole stand or video cart. The surgeon can control the video system's functions via an easy-to-use touchscreen interface, footswitch accessory or wireless control.

The system costs around $25,000. For more information, go to www.leica-microsystems.us, call (800) 248-0123 or circle 168 on your Reader Service Card.

Safebreak Makes Opening Ampules a Snap
Everyone who has broken a hundred or so ampules with bare fingers is bound to have a story or two about getting cut by glass shards. Those who were once hurt and are now worried about it happening again or never want to experience their first prick may want to consider the SafeBreak disposable plastic fracture and safety collar. This device is designed to fit snugly over the ampule's head and will break the bottle open with a squeeze and a snap. No protective gauze pads are necessary and the collar and ampule can be easily thrown away.

Prices for SafeBreak collars range from $6.50 to $12.75 per case of 100, depending on the size of the collars and the quantity of cases ordered. For more information, visit www.medidose.com, e-mail [email protected], call (800) 523-8966 or circle 169 on your Reader Service Card.

Computer System Tracks What Everyone Is Doing
Keeping track of who is where and doing what takes a lot of concentration, and often everyone is so focused on their specific tasks that they don't have time to keep tabs on co-workers. The Radianse Prospective Patient Flow Manager alleviates this burden by collecting location, identity and time information, combining it with information from lab results, order management and other enterprise information systems, then applying logic to associate these elements in the context of patient care. The end result is that medical devices and applications become "situationally aware" and can automatically initiate actions that help patients move throughout the hospital more smoothly and safely.

This system displays all of the information on a heads-up screen for critical hospital staff, helping them to anticipate next steps and respond precisely to improve patient flow. It can locate patients, inform nurses when a lab result is available or when an order has been initiated, alert environmental services when a room is ready to be cleaned and provide real-time metrics for management on length of stay and unit/facility occupancy.

Price varies depending on the options selected and the size of the facility. For more information, visit www.radianse.com, call (800) 974-9302, or circle 170 on your Reader Service Card.

Keep Patients Connected to Their Pumps, Even When on the Go
The popular image of a nurse pushing an IV pump alongside a bed may become an anachronism. The Pump Star by Modular Services Company, engineered to attach quickly and securely to the bed, is designed to free up a staffer by doing all of this work.

The pump rack docks to the bed-mounted plate for patient and equipment mobilization and to eliminate the need to manually carry heavy pumps. When you reach your destination, the pump rack can be quickly undocked from the bed and put onto a stable stand.

The system is designed to be space saving and a bed attached to the Pump Star can still fit into an elevator. It also has a cord management feature for easy storage.

The Pump Star costs around $3,500, depending on the specific package ordered. For more information, visit www.headwalls.com, e-mail [email protected], call (800) 687-0938 or circle 171 on your Reader Service Card.

Make Your Mark Anywhere in the OR
Marking of the surgical site should be standard procedure in your ORs, and now that there's a National Patient Safety Goal calling for the labeling of all medications, medication containers and other solutions, it's all the more important that you have the right tools on hand. If one tool for both these tasks seems like a good idea, you might want to consider TimeMed's Sandel 4-in-1 Marker and labeling kits. The dual-tip, dual-ink marker contains both permanent and gentian ink. It also comes with a colorful sleeve to make it easy to find and remind everyone to take one last check before starting the procedure.

A case of 100 Sandel 4-in-1 Markers lists for $101.59; a case of 100 labeling kits including one marker and eight label (six fill-in and two blank) sheets each lists for $127.63. For more information, visit www.timemed.com, call (800) 323-4840 or circle 172 on your Reader Service Card.