Patient comfort before, during and after a procedure continues to drive
new surgical innovation, and attention from Surgical Products readers.
For details on the development and application of this product, Surgical Products sat
down with Bobby Allen, director of marketing and communications at D.A. Surgical.
Q: What was the thought process
behind developing the ArmGuard
A: To begin with, ArmGuard™ was created
by Dan Allen (president of D. A. Surgical and
inventor of the Allen® Stirrups). The goal was
to develop a safe alternative to tucking arms in the supine position,
offer safe and immediate anesthesia access to ports and lines, to offer
additional versatility for patients with a high BMI, and to make it
practical for robotic surgery.
The design process started with an awareness of AORN patient
arm positioning guidelines for supine positioning. The guidelines
clearly state, “Do not tuck arms unless necessary for surgical reasons”, and they were created due to the incidence of operating room
acquired upper extremity injuries and neuropathy credited to tucking arms with draw sheets.
The guideline reminds us that when a patient's arms are tucked
tightly at his or her side with sheets, it may add unnecessary pressure on the tucked arms and lead to tissue injury and ischemia. It
may also cause interference with physiologic monitoring (e.g., blood
pressure monitoring, arterial catheter monitoring) and result in an
inability to resuscitate during an emergency due to unrecognized IV
infiltration in the tucked arm. There is also an increased risk for the
patient to develop compartment syndrome in the upper extremity.
In discussions with clinicians it was learned that dealing with the
discovery that an IV is obstructed or a monitoring line has become
disconnected requires an immediate response that often requires untucking the arm. We were informed that the act of attempting to re-tuck arms makes a safety hazard of intraprocedural maintenance of
monitor lines and IV’s, especially when the patient is draped, tilted
in 35 degrees of Trendelenburg, and in a darkened room. Several
clinicians described instances where the effects of arm weight and
gravity on a poorly re-tucked arm resulted in the arm “falling out”
and further placing the patient at risk for injury.
Q: How does ArmGuard help to protect the patient, and
what sets it apart from other products?
A: We design devices centered on protecting the patient
from positioning-related risk, with an eye on making the
devices practical and
easy to use. ArmGuard
is no exception. We are
all aware that operating
are an avoidable tragedy.
Tucking arms is linked to
patient injury, and tuck-
ing makes a safety hazard
of intraprocedural main-
tenance of monitoring lines and IVs during the procedure.
We feel that ArmGuard offers the safest alternative to tucking
arms. The reason that customers initially consider ArmGuard is that
they are impressed by the safe environment it creates, and they keep
using it for its versatility and ease of use. Additional features include:
• The only supine arm restraint that gives the anesthesia team clear
visualization for line tracing, as well as immediate and uninter-
rupted maintenance access to IV ports and lines.
• The sled system allows the clinician to control the amount of
compression exerted on the arm in order to avoid hyperextension
and other injury.
• The low profile provides a comfortable environment for surgeons
and bedside assistants.
• Reduced sled profiles eliminate robot arm clash.
• The exclusive restraint sled designs are width adjustable and
accept width extension inserts that safely accommodate patients
with a high BMI.
Q: Does the ArmGuard system fit all operating room
A: The short answer is yes. Two models are offered allowing
ArmGuard to fit or adapt to every OR table in the marketplace.
Q: Could you tell us a little more about D. A. Surgical?
A: The goal of the company is to make devices that make an
important difference in the quality of life of the patients who
come into contact with them. D. A. Surgical is constantly
developing new devices and we distinguish ourselves from
other products because of the functionality and design. Our
core values emphasize patient safety, functionality, ease of use,
surgical site exposure, durability, innovation and value.
1 Tucking patients' arms and general positioning - Bonnie Denholm, RN, MS,
CNOR AORN April 2009Volume 89, Issue 4, Pages 755–757