Abstract:
A surgical positioning aid includes a sheet of foldable material foldable between a flat position and a wrist support position. In the wrist support position, the sheet is folded to form a hump having sufficient strength to support a patient&#39;s wrist in a hyper-extended position during surgery. The sheet also includes a coupler situated at a first end region of the sheet. The coupler is operable to engage an opposite, second end region of the sheet and to hold the sheet in the wrist support position. Many other surgical positioning aid embodiments are also disclosed.

Description:
BACKGROUND 
       [0001]    The present disclosure relates to a positioning aid, for supporting a patient during surgery. More particularly, the present disclosure relates to a support for positioning a portion of a patient&#39;s body during a surgery. 
         [0002]    Often, when a patient is positioned for a surgery, the patient is supported by and secured to braces or supports coupled to a surgical table. Sometimes, positioning aids are inserted at the interface of the patient&#39;s body and the braces or supports to position a portion of the patient&#39;s body. 
         [0003]    Positioning aids known in the art are often impromptu solutions provided by materials at hand at the time of a surgery or procedure. Aids such as pads, towels, or blocks can be difficult for caregivers to arrange and/or rearrange to position a patient as desired for surgery 
       SUMMARY 
       [0004]    A positioning aid has one or more of the features recited in the appended claims and/or the following features which, alone or in any combination, may comprise patentable subject matter: 
         [0005]    A surgical positioning aid for positioning a patient&#39;s wrist is disclosed. The surgical positioning aid may include a sheet of foldable material. The sheet of foldable material may be foldable between a flat position and a wrist support position. In the support position, the sheet may be folded to form a hump having sufficient strength to support a patient&#39;s wrist during surgery. The sheet may also have a coupler at a first end region of the sheet. The coupler may engage a second end region of the sheet to hold the sheet in the wrist support position. The second end region may be opposite the first end region. 
         [0006]    In some embodiments, the sheet may be foldable to a recovery position in which the sheet is folded over itself in a substantially flat configuration. In some such embodiments, the sheet of foldable material may include a locking coupler and a locking coupler receiver. The locking coupler may engage the locking coupler receiver when the sheet of foldable material is folded to the recovery position. 
         [0007]    It is contemplated that the foldable sheet may include at least one living hinge about which the sheet is folded. In such embodiments, the at least one living hinge may form an apex of the hump having sufficient strength to support a patient&#39;s wrist during surgery. 
         [0008]    The coupler at the first end region of the sheet may include a coupler tab bendable out of alignment with the sheet. In such embodiments, the second end region may include a series of coupler tab receivers formed through the sheet and sized to receive the coupler tab. The coupler tab may be defined by a U-shaped slot formed through the sheet. 
         [0009]    According to this disclosure, therefore, a surgical positioning aid may include a flat sheet of foldable material having a first, a second, and a third portion. The first portion may be separated from the second portion by a first living hinge. The third portion may be separated from the second portion by a second living hinge. The sheet may also have a tab. The first portion of the sheet may also have at least one slot to receive the tab. Such a sheet may be movable between a flat position prior to use in surgery and a support position for surgery. In the support position, the second portion may be folded relative to the first portion about the first living hinge and the third portion may be folded relative to the second portion about the second living hinge. Further, the tab may be received in the at least one slot of the first portion such that the first and the second portions cooperate to form a hump relative to the first portion. 
         [0010]    It is contemplated that the hump may include an apex formed by the second living hinge and that the apex may be spaced above the first portion of the sheet. The second living hinge may include at least two series of perforations formed through the sheet providing a gradual bend when the first living hinge is folded. 
         [0011]    In some embodiments, the second portion may form a ramp between the first living hinge and the first portion. The third portion may form a ramp between the second living hinge and the tab. 
         [0012]    The sheet may further be movable to a recovery position wherein the second portion is folded over the first portion about the first living hinge such that the second portion overlies and is substantially parallel to the first portion. In such embodiments, the third portion may be folded relative to the second portion about the second living hinge such that the second and the third portions are substantially flat relative to one another. The second portion of the sheet may include a first locking tab and the first portion of the sheet may include a first locking tab receiver sized to receive the first locking tab. The first locking tab may be received by the first locking tab receiver when the surgical positioning aid is moved to the recovery position so that the locking tab blocks the second portion from unfolding relative to the first portion about the first living hinge. 
         [0013]    The sheet may be formed to include at least one strap slot sized for a strap to extend through the at least one strap slot. In such embodiments, the second portion may be formed to include a first strap slot and the third portion may be formed to include a second strap slot. 
         [0014]    The sheet may include a fourth portion separated from the third portion by a third living hinge. The fourth portion may be formed to include a U-shaped slot defining the tab. The fourth portion may be folded relative to the third portion about the third living hinge so that the fourth portion overlies and is substantially parallel to the first portion when the surgical positioning aid is moved to the support position. 
         [0015]    According to this disclosure, therefore, a surgical positioning aid for radial artery catheterization may be designed to allow for a hemostatic cuff to be in place during the procedure and subsequently applied without the repositioning of the patient&#39;s limb. 
         [0016]    It is contemplated that the cuff is inflatable. The cuff may be made from a flexible material and may act like a tourniquet. 
         [0017]    In some embodiments, the surgical positioning aid may include a means for securing the aid to a fixed surface. The surgical positioning aid may be operable to support a patient&#39;s entire arm. The surgical positioning aid may be made from a semi-rigid foam. The surgical positioning aid may include a thin rigid portion. 
         [0018]    It is therefore disclosed that a surgical positioning aid for radial artery catheterization may include an arm support portion and a curved portion operable to position a patient&#39;s wrist in a hyper-extended position. 
         [0019]    The surgical positioning may be configured to couple to a surgical table. In some embodiments, the surgical positioning aid may be radiolucent. The arm support portion may include a coupler portion configured to extend between a section of a surgical table and a mattress so that the surgical positioning aid is coupled to a surgical table. 
         [0020]    Additional features, which alone or in combination with any other feature(s), such as those listed above and those listed in the claims, may comprise patentable subject matter and will become apparent to those skilled in the art upon consideration of the following detailed description of various embodiments exemplifying the best mode of carrying out the embodiments as presently perceived. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0021]    The detailed description particularly refers to the accompanying figures, in which: 
           [0022]      FIG. 1  is a perspective view of a surgical positioning aid including a foldable sheet showing the sheet folded into a support position, the sheet supporting a patient&#39;s wrist in a hyper-extended position; 
           [0023]      FIG. 2  is a perspective view of the surgical positioning aid of  FIG. 1  showing the foldable sheet folded into a recovery position in which a patient&#39;s wrist is supported by the aid in a substantially flat configuration; 
           [0024]      FIG. 3  is a top plan view of the surgical positioning aid of  FIG. 1  showing the foldable sheet in a stored position wherein a base portion, an arm portion, a hand portion, and a tab portion are substantially flat; 
           [0025]      FIG. 4  is a perspective view of the surgical positioning aid of  FIG. 1  showing a coupler tab formed in the tab portion of the foldable sheet being bent out of the sheet for insertion into a coupler tab receiver formed in a base portion of the foldable sheet; 
           [0026]      FIG. 5  is a perspective view of the surgical positioning aid of  FIG. 1  showing the coupler tab inserted into the coupler tab receiver; 
           [0027]      FIG. 6  is a side elevation view of the surgical positioning aid of  FIG. 1  showing the foldable sheet in a support position and the arm portion cooperating with the hand portion of the foldable sheet forming a hump for supporting a patient&#39;s wrist at a low angle of hyper-extension; 
           [0028]      FIG. 7  is a side elevation view of the surgical positioning aid of  FIG. 1  showing the foldable sheet in a support position and the arm portion cooperating with the hand portion of the foldable sheet forming a hump for supporting a patient&#39;s wrist at a medium angle of hyper-extension; 
           [0029]      FIG. 8  is a side elevation view of the surgical positioning aid of  FIG. 1  showing the foldable sheet in a support position and the arm portion cooperating with the hand portion of the foldable sheet forming a hump for supporting a patient&#39;s wrist at a high angle of hyper-extension; 
           [0030]      FIG. 9  is a perspective detail view of the surgical positioning aid of  FIG. 1  showing a lock tab formed in the arm portion of the foldable sheet and a lock tab receiver formed in the base portion of the foldable sheet; 
           [0031]      FIG. 10  is a perspective detail view of the surgical positioning aid of  FIG. 1  showing the lock tab bent down and into engagement with the lock tab receiver; 
           [0032]      FIG. 11  is a side elevation detail view of the surgical positioning aid of  FIG. 1  showing the lock tab bent down and into engagement with the lock tab receiver blocking the arm portion of the foldable sheet from unfolding away from the base portion of the foldable sheet; 
           [0033]      FIG. 12  is a perspective view of an alternative surgical positioning aid supporting a patient&#39;s wrist in a hyper-extended position, the aid including a block with a convex top profile between an arm end and a hand end of the block, the aid also including an arm strap, a hand strap, and an inflatable cuff; 
           [0034]      FIG. 13  is a side elevation view of the surgical positioning aid of  FIG. 12  showing the block including an arm strap slot, a hand strap slot, and a cuff slot; 
           [0035]      FIG. 14  is a cross-sectional view taken along line  14 - 14  of  FIG. 13  showing a concave profile between a left and a right side of the block for centering a patient&#39;s wrist when the patient&#39;s wrist is supported on the body; 
           [0036]      FIG. 15  is a side elevation view of an alternative surgical positioning aid including a block with a convex top profile between an arm end and a hand end, the aid also including a first strap groove and a second strap groove; 
           [0037]      FIG. 16  is a side elevation view of an alternative surgical positioning aid including a thin body forming a convex profile extending between an arm end and a hand end of the body to support a patient&#39;s wrist in a hyper-extended position; 
           [0038]      FIG. 17  is a cross sectional view taken along line  17 - 17  of  FIG. 16  showing a concave profile of the body between a right and a left side of the body for centering a patient&#39;s wrist when the patient&#39;s wrist is supported on the body; 
           [0039]      FIG. 18  is a side elevation view of an alternative surgical positioning aid including a thin body, a first flat coupling portion extending beyond an arm end of the body, and a second flat coupling portion extending beyond a hand end of the body, the thin body forming a convex profile extending between an arm end and a hand end of the body to support a patient&#39;s wrist in a hyper-extended position; 
           [0040]      FIG. 19  is a top plan view of an alternative surgical positioning aid showing the aid in a flat stored configuration, the aid including a T-shaped body with a strap extending through slots formed in a stem of the body; 
           [0041]      FIG. 19A  is a side elevation view of the surgical positioning aid of  FIG. 19  showing the aid in a support position for supporting a patient&#39;s wrist in a hyper-extended position and the aid coupled to an arm board by a strap and a pair of wings; 
           [0042]      FIG. 20  is a top plan view of an alternative surgical positioning aid showing the aid in a flat stored configuration, the aid including an I-shaped body; 
           [0043]      FIG. 20A  is a side elevation view of the surgical positioning aid of  FIG. 20  showing the aid in a support position for supporting a patient&#39;s wrist in a hyper-extended position and the aid coupled to an arm board by wings at both ends of a stem; 
           [0044]      FIG. 21  is a side elevation view of the surgical positioning aid of  FIG. 20  showing the aid in a flat stored configuration; 
           [0045]      FIG. 22  is a side elevation view of an alternative surgical positioning aid including a contoured pad with an arm support portion unitarily formed with a block portion, the arm support portion configured to support a patient&#39;s whole arm and the block portion including a convex top profile for supporting a patient&#39;s wrist in a hyper-extended position; 
           [0046]      FIG. 23  is a side elevation view of an alternative surgical positioning aid for use with a thin mattress pad including a thin body portion, a thin arm support portion, and a thin pad, the thin body portion configured to support a patient&#39;s wrist in a hyper-extended position and the thin arm support portion configured to support a patient&#39;s whole arm; 
           [0047]      FIG. 24  is a side elevation view of an alternative surgical positioning aid for use with a thick mattress pad including a thin body portion, a step portion, a thin arm support portion, and a thin pad, the thin body portion configured to support a patient&#39;s wrist in a hyper-extended position and the thin arm support portion configured to support a patient&#39;s whole arm; 
           [0048]      FIG. 25  is a side elevation view of an alternative surgical positioning aid including an inflatable bladder, an arm strap, and a hand strap wherein the inflatable bladder is situated beneath a patient&#39;s wrist and is inflatable to support a patient&#39;s wrist in a hyper-extended position; 
           [0049]      FIG. 26  is a side elevation view of the surgical positioning aid of  FIG. 25  showing the inflatable bladder in a deflated position moving a patient&#39;s wrist to a substantially flat recovery position; and 
           [0050]      FIG. 27  is a side elevation view of an alternative surgical positioning aid including a block with a decline ramp and a removable slug configured to be situated between the decline ramp and a patient&#39;s hand when the patient&#39;s wrist is moved to a substantially flat recovery position. 
       
    
    
     DETAILED DESCRIPTION 
       [0051]    An illustrative surgical positioning aid  10  used for positioning a patient&#39;s arm, hand, and wrist during and after trans-radial cardiac catheterizations is shown in  FIG. 1 . In other embodiments, the surgical positioning aid  10  may be scaled up or down in size for positioning other parts of a patient during other surgeries or operations including but not limited to: positioning a patient&#39;s knee relative to a patient&#39;s hip during hip surgery or positioning a patient&#39;s head relative to a patient&#39;s torso for tracheal tube placement. 
         [0052]    The aid  10  is illustratively a sheet of plastics material and includes a base portion  12 , an arm portion  14 , a hand portion  16 , and a tab portion  18 . The base portion  12  is situated at a first edge  19  of the aid  10 . The tab portion  18  is situated at a second edge  21  of the aid  10 . The aid  10  is movable between a flat position for storage (as shown in  FIG. 3 ), a support position for supporting a patient&#39;s arm, hand, and wrist, while the patient&#39;s wrist is in a hyper-extended position during trans-radial cardiac catheterizations (as shown in  FIG. 1 ), and a recovery position for supporting a patient&#39;s arm, hand, and wrist during recovery from trans-radial cardiac catheterizations (as shown in  FIG. 2 ). 
         [0053]    The base portion  12  of the aid  10  is coupled to the arm portion  14  by a first living hinge  20  situated between the base portion  12  and the arm portion  14 . The arm portion  14  of the aid  10  is coupled to the hand portion  16  by a second living hinge  22  situated between the arm portion  14  and the hand portion  16 . The hand portion  16  of the aid  10  is coupled to the tab portion  18  by a third living hinge  24  situated between the hand portion  16  and the tab portion  18 . 
         [0054]    The first living hinge  20  is formed by a series of perforations  26  extending through the aid  10  arranged in a linear pattern between a top edge  27  and a bottom edge  29  of the aid  10 . The first living hinge  20  is configured to provide sharp bend between the base portion  12  and the arm portion  14 . In other embodiments, the first living hinge  20  may be formed by a thinned section of the aid  10  between the base portion  12  and the arm portion  14 . 
         [0055]    The second living hinge  22  is illustratively formed by a first series of perforations  28 , a second series of perforations  30 , and a third series of perforations  32  extending through the aid  10  and arranged in linear patterns between the top edge  27  and the bottom edge  29  of the aid  10 . The second living hinge  22  is configured to provide gradual bend between the arm portion  14  and the hand portion  16 . In other embodiments, the second living hinge  22  may be formed by a thinned section of the aid  10  between the arm portion  14  and the hand portion  16 . In such embodiments, the thinned section of the second living hinge may extend a greater distance between the first edge  19  and the second edge  21  of the aid  10  than a thinned section forming the first living hinge. 
         [0056]    The third living hinge  24  is formed by a series of perforations  34  extending through the aid  10  arranged in a linear pattern between the top edge  27  and the bottom edge  29  of the aid  10  as shown in  FIG. 3 . The third living hinge  24  is configured to provide a sharp bend between the hand portion  16  and the tab portion  18 . In other embodiments, the third living hinge  24  may be formed by a thinned section of the aid  10  between the hand portion  16  and the tab portion  18 . 
         [0057]    The tab portion  18  of the aid  10  includes a coupler tab  36  for selectively securing the hand portion  16  to the base portion  12 . The coupler tab  36  is defined by a U-shaped slot  38  formed through the aid  10 . The coupler tab  36  is configured to be bent down from the aid  10  by a caregiver as shown in  FIG. 4 . In some embodiments, rather than the coupler tab  36 , an adhesive, complementary patches of hook and loop material, or another securing arrangement may be used for selectively securing the hand portion  16  to the base portion  12 . 
         [0058]    The arm portion  14  of the aid  10  includes a first lock tab  37  and a second lock tab  39 . The first lock tab  37  is formed along the top edge  27  of the aid  10 . The second lock tab  39  is formed along the bottom edge  29  of the aid  10 . The first and the second lock tabs  37 ,  39  are configured to be bent down from the aid  10  by a caregiver as shown in  FIG. 9 . 
         [0059]    As shown in  FIG. 3 , the base portion  12  of the aid  10  includes a series of coupler tab receivers  40  extending through the aid  10  and sized to receive the coupler tab  36 . The series of coupler tab receivers  40  includes coupler tab receivers  42 ,  44 ,  46 ,  48 ,  50 . The base portion  12  also includes a first lock tab receiver  47  and a second lock tab receiver  49 . The first lock tab receiver  47  is formed in the top edge  27  of the aid  10  and the second lock tab receiver  49  is formed in the bottom edge  29  of the aid  10 . The first and the second lock tab receivers  47 ,  49  are sized to receive the first lock tab  37  and the second lock tab  39 , respectively. 
         [0060]    When the aid  10  is in the stored position, the aid  10  is substantially flat. Also, the base portion  12  is spaced apart from the tab portion  18 . Further, neither the coupler tab  36  nor the first and the second lock tabs  37 ,  39  are bent down from the aid  10 . Thus, the aid  10  is easily stored or stacked in the stored position. 
         [0061]    To move the aid  10  from the stored position to the support position, the first living hinge  20  is bent so that the arm portion  14  extends over the base portion  12  forming an angle α between the base portion  12  and the arm portion  14 . Thus, the base portion  12  and the arm portion  14  form a first ramp  51 . Additionally, the second living hinge  22  is gradually bent so that the second living hinge  22  forms an apex  52  spaced above the base portion  12 . Further, the hand portion  16  extends from the apex  52  to the base portion  12  so that the hand portion  16  extends over the base portion  12  forming an angle β between the base portion  12  and the hand portion  16 . Thus, the base portion  12  and the hand portion  16  form a second ramp  54 . Finally, the third living hinge  24  is bent so that the tab portion  18  overlies and is substantially parallel to the base portion  12 . In some embodiments, additional straps may be wrapped around the base portion  12  and an arm board or other support to secure the aid  10  relative to an overall patient support. In other embodiments, the base portion  12  may include additional tabs that are operable to be bent down and secured to an arm board having slots to receive the additional tabs, thereby securing the aid relative to an overall patient support. 
         [0062]    When the aid  10  is moved to the support position, the arm portion  14  is operable to support a patient&#39;s arm, the hand portion  16  is operable to support a patient&#39;s hand, and the second living hinge  22  is operable to support a patient&#39;s wrist in a hyper-extended position suitable for catheterization. Also, the coupler tab  36  is bent down from the tab portion  18  of the aid  10  and is inserted into one of coupler tab receivers  42 ,  44 ,  46 ,  48 ,  50  so that the positions of the arm portion  14  and the hand position  16  are maintained relative to the base portion  12 . 
         [0063]    In the support position, the angles α, β are adjustable depending on which coupler tab receiver  42 ,  44 ,  46 ,  48 ,  50  receives the coupler tab  36 . Thus, a physician may adjust the angle at which a patient&#39;s wrist is hyper-extended among a series of angles as shown in  FIGS. 6-8 . The physician may adjust the angle of hyper-extension for a catheterization depending on physician preference, patient flexibility, and other factors. In some embodiments, while the aid  10  is in the support position, the angle of a patient&#39;s hyper-extended wrist may be between 35 and 65 degrees. In some embodiments an occlusion band may have an inflatable hemostatic cuff and the occlusion band may be passed between the base portion  12  and the overlying arm portion  14  for use before, after or during a catheterization. In some such embodiments, the occlusion band may be made from a flexible material and may act as a tourniquet. 
         [0064]    To move the aid  10  from the support position to the recovery position, the first living hinge  20  is further bent so that the arm portion  14  overlies and is substantially parallel to the base portion  12 . Additionally, the second living hinge  22  is unbent so that the hand portion  16  is flattened relative to the arm portion  14 . Further, the hand portion  16  in the recovery position overlies and is substantially parallel to the base portion  12 . In the recovery position, the angle α is about 180 degrees and the angle β is about 0 degrees. Thus, in the recovery position, a patient&#39;s wrist is moved away from the hyper-extended position. 
         [0065]    When the aid  10  is moved to the recovery position, the arm portion  14  is operable to support a patient&#39;s arm, the hand portion  16  is operable to support a patient&#39;s hand, and the second living hinge  22  is operable to support a patient&#39;s wrist in a substantially flattened position suitable for recovery. Also, the coupler tab  36  is removed from the coupler tab receivers  42 ,  44 ,  46 ,  48 ,  50  and is moved back into alignment with the aid  10 . Additionally, the lock tabs  37 ,  39  are bent down from the arm portion  14  and are inserted into the lock tab receivers  47 ,  49 , respectively. When the lock tabs  37 ,  39  are inserted into the lock tab receivers  47 ,  49  the aid  10  is locked in the recovery position. The lock tabs  37 ,  39  are operable to move into and out of the lock tab receivers  47 ,  49  while a patient&#39;s arm, hand, and wrist are supported on the aid  10 . Thus, the aid  10  is movable from the support position to the recovery position while a patient&#39;s arm, hand, and wrist remain supported on the aid  10 . In some embodiments an occlusion band may have an inflatable hemostatic cuff and the band may be passed between the base portion  12  and the overlying arm portion  14  so that the occlusion band may be secured over a patient&#39;s arm to slow circulation to a catheter insertion point before, during or after a catheterization. In some such embodiments, the occlusion band may be made from a flexible material and may act as a tourniquet. 
         [0066]    The arm portion  14  also includes a first arm strap slot  57 , a second arm strap slot  59 , and an arm strap  60 . The first and the second arm strap slots  57 ,  59  extend through the aid  10  and are situated near the top and the bottom edges  27 ,  29  of the aid, respectively. The arm strap  60  extends through the first and the second arm strap slot  57 ,  59  and is operable to be wrapped around and secure a patient&#39;s arm to the arm portion  14  of the aid  10 . In the illustrative embodiment, the arm strap  60  includes a hook material face  62  and a loop material face  64  so that the arm strap  60  can be secured to itself. In other embodiments, the arm strap  60  may include clasps, hooks, snaps or the like to secure a patient&#39;s arm to the arm portion  14  of the aid  10 . 
         [0067]    The hand portion  16  also includes a first hand strap slot  67 , a second hand strap slot  69 , and a hand strap  70 . The first and the second hand strap slots  67 ,  69  extend through the aid  10  and are situated near the top and the bottom edges  27 ,  29  of the aid, respectively. The hand strap  70  extends through the first and the second hand strap slots  67 ,  69  and is operable to be wrapped around and secure a patient&#39;s hand to the hand portion  16  of the aid  10 . In the illustrative embodiment, the hand strap  70  includes a hook material face  72  and a loop material face  74  so that the hand strap  70  can be secured to itself. In other embodiments, the hand strap  70  may include clasps, hooks, snaps or the like to secure a patient&#39;s hand to the hand portion  16  of the aid  10 . 
         [0068]    An alternative positioning aid  210  is shown in  FIGS. 12-14 . The positioning aid  210  includes a block  212 , an arm strap  214 , a hand strap  216 , and an inflatable cuff  218 . The block  212  has a convex profile  220  extending longitudinally across the top of the block  212  between an arm end  223  and a hand end  225  of the block  212  as shown in  FIGS. 12 and 13 . The convex profile  220  forms an incline ramp  217 , a decline ramp  219 , and an apex  221 . The incline ramp  217  extends from the arm end  223  of the block to the apex  221  and is operable to support a patient&#39;s arm. The decline ramp  219  extends from the apex  221  to the hand end  225  of the block  212  and is operable to support a patient&#39;s hand. The convex profile  220  is operable to support a patient&#39;s wrist in a hyper-extended position as shown in  FIG. 12 . 
         [0069]    The block  212  forms an arm strap slot  224 , a hand strap slot  226 , and a cuff slot  228 . The arm strap slot  224  extends through the block  212  and is oriented to run between a left side  227  and a right side  229  of the block as shown in  FIG. 14 . Additionally, the arm strap slot  224  is situated near the arm end  223  of the block  212 . The hand strap slot  226  extends through the block  212  and is oriented to run between the left side  227  and the right side  228  of the block  212 . The hand strap slot  226  is situated near the hand end  225  of the block  212 . The cuff slot  228  extends through the block  212  and is oriented to run between the left side  227  and the right side  229  of the block  212 . The cuff slot  228  is situated between the arm strap slot  224  and the hand strap slot  226  as shown in  FIGS. 12 and 13 . 
         [0070]    The arm strap  214  is sized to extend through the arm strap slot  224  and is operable to wrap around and secure a patient&#39;s arm to the block  212 . The hand strap  216  is sized to extend through the hand strap slot  226  and is operable to wrap around and secure a patient&#39;s hand to the block  212 . The inflatable cuff  218  is sized to extend through the cuff slot  228  and is operable to occlude arteries in the arm after a trans-radial cardiac catheterization or other procedure. 
         [0071]    The positioning aid  210  is configured to be coupled to an arm board  230  and also includes a first board strap  232  and a second board strap  234 . The block  212  is illustratively made of foam and includes a first board strap slot  236  and a second board strap slot  238 . The first and the second board straps  236 ,  238  extend through the block  212  and run between the left side  227  and the right side  229  of the block  212 . The first and the second board straps  232 ,  234  are operable to wrap around the arm board  230  and to secure the block  212  to the arm board  230 . 
         [0072]    The block  212  has a concave profile  240  extending laterally across the top of the block  212  between the left side  227  and the right side  229  of the block  212  as shown in  FIG. 14 . The concave profile  240  is operable to center a patient&#39;s wrist supported by the block  212 . The concave profile  240  extends along the entire length of the block  212 . 
         [0073]    Another alternative positioning aid  310  is shown in  FIG. 15 . The positioning aid  310  includes a block  312 , a first board strap  214 , and a second board strap  216 . The block  312  is illustratively made of foam and has a convex profile  320  extending longitudinally across the top of the block  312  between an arm end  323  and a hand end  325  of the block  312  as shown in  FIG. 15 . The convex profile  320  forms an incline ramp  317 , a decline ramp  319 , and an apex  321 . The incline ramp  317  extends from the arm end  323  of the block to the apex  321  and is operable to support a patient&#39;s arm. The decline ramp  319  extends from the apex  321  to the hand end  325  of the block  312  and is operable to support a patient&#39;s hand. The convex profile  320  is operable to support a patient&#39;s wrist in a hyper-extended position. 
         [0074]    The block  312  forms a first strap groove  324  and a second strap groove  326 . The first and the second strap grooves  324 ,  326  extend downwardly from the convex profile  320  of the block  312 . The first and the second strap grooves  324 ,  326  are also sized to receive the first and the second board straps  314 ,  316 , respectively. As shown in  FIG. 15 , the first and the second board straps  314 ,  316  overlie the block  212  in the strap grooves  324 ,  326  and are operable to secure the block  312  to an arm board  330 . In some embodiments, the positioning aid  310  may include an arm strap and a hand strap operable to wrap around a patient&#39;s arm and hand securing the patient to the block  312 . 
         [0075]    Still another alternative positioning aid  410  is shown in  FIG. 16-17 . The positioning aid  410  includes a thin rigid body  412 , an arm strap  414 , a hand strap  416 , and a board strap  418 . The body  412  is illustratively made from a sheet of plastics material and has a thickness of about ⅛ th  inch to about 1 inch. The body  12  has a convex profile  420  extending longitudinally across the top of the body  412  between an arm end  423  and a hand end  425  of the body  412  as shown in  FIG. 16 . The convex profile  420  forms an incline ramp  417 , a decline ramp  419 , and an apex  421 . The incline ramp  417  extends from the arm end  423  of the body  412  to the apex  421  and is operable to support a patient&#39;s arm. The decline ramp  419  extends from the apex  421  to the hand end  425  of the body  412  and is operable to support a patient&#39;s hand. The convex profile  420  is operable to support a patient&#39;s wrist in a hyper-extended position as shown in  FIG. 16 . 
         [0076]    The arm strap  414  wraps around the incline ramp  417  and is operable to wrap around a patient&#39;s arm to secure the patient&#39;s arm to the incline ramp  417 . The hand strap  416  wraps around the decline ramp  419  and is operable to wrap around a patient&#39;s hand to secure the patient&#39;s hand to the decline ramp  419 . The board strap  418  is situated near the apex  421  of the body  412  and is illustratively secured to the body  412  by an adhesive. The board strap  418  is operable to wrap around an arm board  430  to secure the positioning aid  410  to the arm board  430 . 
         [0077]    The body  412  has a concave profile  440  extending laterally across the top of the body  412  between a left side  427  and a right side  429  of the body  412  as shown in  FIG. 17 . The concave profile  440  is operable to center a patient&#39;s wrist supported by the body  412 . The concave profile  440  extends along the entire length of the body  412 . 
         [0078]    Another alternative positioning aid  510  is shown in  FIG. 18 . The positioning aid  510  includes a thin rigid body  512 , an arm strap  514 , a hand strap  516 , a first board strap  518   a,  and a second board strap  518   b.  The body  512  is illustratively made from a sheet of plastics material and has a thickness of about ⅛ th  inch to about 1 inch. The body  12  has a convex profile  520 , a first flat coupling portion  522 , and a second flat coupling portion  524 . The convex profile  520  extends longitudinally across the top of the body  512  between the first and the second flat coupling portions  522 ,  524 . The first flat coupling portion  522  extends from an arm end  523  of the body  512  to the beginning of the convex profile  520 . The second flat coupling portion  524  extends from a hand end  525  of the body  512  to the convex profile  520 . 
         [0079]    The convex profile  520  forms an incline ramp  517 , a decline ramp  519 , and an apex  521 . The incline ramp  517  extends from the arm end  523  of the body  512  to the apex  521  and is operable to support a patient&#39;s arm. The decline ramp  519  extends from the apex  521  to the hand end  525  of the body  512  and is operable to support a patient&#39;s hand. The convex profile  520  is operable to support a patient&#39;s wrist in a hyper-extended position as shown in  FIG. 18 . 
         [0080]    The arm strap  514  wraps around the incline ramp  517  and is operable to wrap around a patient&#39;s arm to secure the patient&#39;s arm to the incline ramp  517 . The hand strap  516  wraps around the decline ramp  519  and is operable to wrap around a patient&#39;s hand to secure the patient&#39;s hand to the decline ramp  519 . The first and the second board strap  518   a,    518   b  wraps around the first and the second flat coupling portion  522 ,  524 , respectively, and an arm board  530  to secure the positioning aid  510  to the arm board  530 . 
         [0081]    Yet another alternative positioning aid  610  is shown in  FIGS. 19 and 19A . Aid  610  includes a pliable body  612  and a securing strap  614 . The body  612  is made from an annealed aluminum sheet core  616  coated in an ethylene foam coating  618 . In other embodiments, the core  616  may be made from some other flexible material and the coating  618  may be some other material such as a gel, a plastic, or another foam. 
         [0082]    The body  612  is T-shaped with a stem  620  and wings  622 ,  624  extending laterally away from the stem  620 . The stem  620  is formed to include a first and a second strap slot  626 ,  628  near an arm end  623  of the body  612 . The wings  622 ,  624  form a hand end  625  of the body  612 . The securing strap  614  extends through the first and the second strap slot  626 ,  628 . The securing strap  614  is operable to be wrapped around an arm board  630  to secure the aid  610  to the arm board  630 . 
         [0083]    The body  612  is movable between a storage position where the body  612  is flat and a support position where the stem  620  of the body  612  is bent to form an incline ramp  617 , a decline ramp  619 , and an apex  621  as shown in  FIG. 19A . The incline ramp  617  extends from the arm board  630  to the apex  621  and is operable to support a patient&#39;s arm. The decline ramp  619  extends from the apex  621  to arm board  630  and is operable to support a patient&#39;s hand. The body  612  in the support position is operable to support a patient&#39;s wrist over the apex  621  in a hyper-extended position. Also, when the body is moved to the support position, the wings  622 ,  624  are bent down to wrap around an arm board. Further, when the body  612  is moved to the support position, the securing strap  614  is wrapped around the arm board securing the aid  610  to the arm board. In some embodiments, the body  612  is further bent in the support position to form a convex shape between a left and a right side of the body  12 . 
         [0084]    Another alternative positioning aid  710  is shown in  FIGS. 20 ,  20 A, and  21 . Aid  710  includes a pliable body  712  made from an annealed aluminum sheet core  716  coated in an ethylene foam coating  718 . In other embodiments, the core  716  may be made from some other flexible material and the coating  718  may be some other material such as a gel, a plastic, or another foam. 
         [0085]    The body  712  is I-shaped with a stem  720 , hand wings  722 ,  724  and arm wings  726 ,  728 . The hand wings  722 ,  724  extend laterally away from the stem  720  and form a hand end  725  of the body  712 . The arm wings  726 ,  728  extend laterally away from the stem  720  and form an arm end of the body  723 . 
         [0086]    The body  712  is movable between a storage position where the body  712  is flat (as shown in  FIG. 21 ) and a support position where the stem  720  of the body  712  is bent to form an incline ramp  717 , a decline ramp  719 , and an apex  721  as shown in  FIG. 20A . The inclined ramp  717  extends from the arm board  730  to the apex  721  and is operable to support a patient&#39;s arm. The decline ramp  719  extends from the apex  721  to arm board  730  and is operable to support a patient&#39;s hand. The body  712  in the support position is operable to support a patient&#39;s wrist at the apex  721  in a hyper-extended position. Also, when the body is moved to the support position, the hand wings and the arm wings  722 ,  724 ,  726 ,  728  are bent down to wrap around an arm board as shown in  FIG. 20A . In some embodiments, the body  712  is further bent in the support position to form a convex shape between a left and a right side of the body  712 . 
         [0087]    Still another positioning aid  810  is shown in  FIG. 22 . Positioning aid  810  includes a contoured pad  812 , an arm strap  814 , a hand strap  816 , a first board strap  818   a , and a second board strap  818   b.  The contoured pad  812  is illustratively made of foam and includes an arm support portion  820  unitarily formed with a block portion  822 . The block portion  822  is substantially similar to the positioning aid  210  in  FIGS. 12-14  and similar reference numbers are used to denote like features. 
         [0088]    The arm support portion  820  extends along the length of an arm board  830 . In some embodiments, the arm board  830  and the positioning aid  810  are radiolucent to allow imaging of a patient supported on the aid  810 . The arm board  830  includes a clamp  831  and is operable to couple to an operating room table  832  with an accessory rail  833 . The arm support portion is sized to have a thickness similar to that of a mattress  834  supported on the operating room table  832 . The arm support portion  820  includes a first arm strap slot  838   a  and a second arm strap slot  838   b  spaced apart from one another. The first and the second board straps  818   a,    818   b  extend through the first and the second arm strap slots  838   a,    838   b  and wrap around the arm board  830  to secure the positioning aid  810  to the arm board  830 . 
         [0089]    Yet another positioning aid  910  is shown in  FIG. 23 . The positioning aid  910  includes a thin body portion  912 , a thin arm support portion  914 , and a thin pad  916 . The thin body portion  912  is unitarily formed with the thin arm support  914  and both are illustratively made of a sheet of plastics material with a thickness of about ⅛ th  inch to about 3 inches. In other embodiments, the thin body portion  912  and the thin arm support  914  may be made from carbon fiber, wood, or some other suitable material. The thin body portion  912  is substantially similar to the positioning aid  410  shown in  FIGS. 16 and 17  and similar reference numbers are used to denote like features. 
         [0090]    The positioning aid  910  is configured to be used with an operating room table  920  with a table section  922  and a thin mattress pad  924 . The thin arm support  914  includes a coupling portion  930  and a support portion  932 . The coupling portion  930  of the thin arm support  914  extends between the table section  922  and the thin mattress pad  924  such that the aid  910  is held in place relative to the operating room table  920 . The aid  910  is further held in place relative to the operating room table  920  by a patient&#39;s weight when a patient is supported on the mattress pad  924 . The support portion  932  of the thin arm support  914  extends between the thin mattress pad  924  and the thin body portion  912  and is operable to support a patient&#39;s arm. 
         [0091]    The thin pad  916  is illustratively a gel pad with a thickness of about ⅛ th  inch to about 1 inch. The thin pad  916  overlies the thin body portion  912  and the support portion  932  of the thin arm support  914 . In other embodiments, the thin pad  916  may be made from foam or other padding material. In some embodiments, the thin body  912 , the thin arm support  914 , and the thin pad  916  may be covered by a disposable cover. 
         [0092]    Another alternative positioning aid  1010  is shown in  FIG. 24 . The positioning aid  1010  includes a thin body portion  1012 , a thin arm support  1014 , and a thin pad  1016 . The thin body portion  1012  is unitarily formed with the thin arm support  1014  and both are illustratively made from a sheet of plastics material with a thickness of about ⅛ th  inch to about 3 inches. The thin body portion  1012  is substantially similar to the positioning aid  410  shown in  FIGS. 16 and 17  and similar reference numbers are used to denote like features. 
         [0093]    The positioning aid  1010  is configured to be used with an operating room table  1020  with a table section  1022  and a thick mattress pad  1024 . The thin arm support  1014  has a coupling portion  1030 , a step portion  1031 , and a support portion  1032  all illustratively made from a plastics material. In other embodiments, the thin arm support  1014  may be made from carbon fiber, wood, or some other suitable material. The coupling portion  1030  of the thin arm support  1014  extends between the table section  1022  and the thick mattress pad  1024  such that the aid  1010  is held in place relative to the operating room table  1020 . The aid  1010  is further held in place relative to the operating room table  1020  by a patient&#39;s weight when a patient is supported on the mattress pad  1024 . The step portion of the thin arm support  1014  extends upwardly from the coupling portion  1030 . The support portion  1032  of the thin arm support  1014  extends from the step portion  1031  to the thin body portion  1012  and is operable to support a patient&#39;s arm. The step portion  1031  is sized such that the thin pad  1016  is flush with the top of the thick mattress pad  1024 . 
         [0094]    The thin pad  1016  is illustratively a gel pad with a thickness of about ⅛ th  inch to about 1 inch. The thin pad  1016  overlies the thin body portion  1012  and the support portion  1032  of the thin arm support  1014 . In other embodiments, the thin pad  1016  may be made from foam or other padding material. In some embodiments, the thin body  1012 , the thin arm support  1014 , and the thin pad  1016  may be covered by a disposable cover. 
         [0095]    Yet another alternative positioning aid  1110  is shown in  FIGS. 25 and 26 . The positioning aid  1110  includes and inflatable bladder  1112 , an arm strap  1114 , a hand strap  1116 , and an arm board  1118 . The arm strap  1114  is operable to wrap around the arm board  1118  and to secure a patient&#39;s arm to the arm board  1118 . The hand strap  1116  is operable to wrap around the arm board  1118  and to secure a patient&#39;s hand to the arm board  1118 . The inflatable bladder  1112  is coupled to the arm board  1118  and situated between the arm strap  1114  and the hand strap  1116  so as to underlie a patient&#39;s wrist. 
         [0096]    The inflatable bladder  1112  is coupled to a pressure source  1120  and a vent  1122 . The pressure source  1120  is operable to inflate the bladder  1112 . The pressure source  1120  may be a squeeze bulb, a blower, a compressor, a bellows, a compressed air tank, or any other suitable pressure source. The vent  1122  is coupled to the atmosphere  1124  and is operable to deflate the bladder  1112  when the vent is moved to an open position. The inflatable bladder  1112  is movable between a support position, shown in  FIG. 25 , and a recovery position, shown in  FIG. 26 . In the support position, the inflatable bladder  1112  is inflated by the pressure source  1120  to support a patient&#39;s wrist in a hyper-extended position. In the recovery position, the inflatable bladder  1112  is deflated by the opening the vent  1122  so that a patient&#39;s wrist is supported in a substantially flat position. 
         [0097]    Still another alternative positioning aid  1210  is shown in  FIG. 27 . The aid  1210  includes a block  1212  and a removable slug  1214 . The block  1212  forms a decline ramp  1216  extending downwardly from a top surface  1218  of the block  1212 . The top surface  1218  of the block  1212  is operable to support a patient&#39;s arm. The slug  1214  is placed by a surgeon or a caregiver between a patient&#39;s hand and the decline ramp  1216  at the desired location. In the illustrative embodiment, the slug  1214  has a round cross section to allow the slug to be rolled down the decline ramp  1216  for removal. In other embodiments, the slug  1214  has other cross sectional shapes. 
         [0098]    The aid  1210  is movable between a recovery position and a support position. In the recovery position, the slug  1214  is situated between the decline ramp  1216  and a patient&#39;s hand so that the patient&#39;s wrist is supported in a substantially flat configuration as shown in  FIG. 27 . In the support position, the slug  1214  is moved away from the decline ramp so that a patient&#39;s hand is supported by the decline ramp  1216  and a patient&#39;s wrist is supported at a hyper-extended angle. 
         [0099]    Although certain illustrative embodiments have been described in detail above, variations and modifications exist within the scope and spirit of this disclosure as described and as defined in the following claims.