Ergonomics Quiz (Patient Care)

MSK means

Musculoskeletal

MSD means

Musculoskeletal disorder

MSI means

Musculoskeletal injury

RSI means

Repetitive strain injury

WRMSD means

Work related musculoskeletal disorder

What is Ergonomics?

Fitting a workplace to the user’s needs

Changing work station, equipment, tools to reduce stress on the body

Goal is to reduce discomfort, WRMSD, increase productivity

What is Musculoskeletal injury/disorder?

Conditions that cause injury to muscles, tendons, ligaments

Common causes: poor posture, repetitive motion, excessive force

What are the statistics of sonographers in pain?

80-95% of sonographers experience work related pain

90% experience pain for more than half of career

1 in 5 have a career ending work injury

What’s the MAIN cause of MSK injury?

Repetitive motions (RSI = repetitive strain injury)

What to avoid when scanning?

• Poor posture (i.e., gripping transducer, arms out)

• Awkward position (i.e., extending arm, twisting back or rotating)

What angle should your shoulder be when scanning?

Less than 30 degrees

Examples of sonography workplace stress

High stress/work pressure

Staff shortage

Case load (more exams, less time)

Obese patient population

Signs of developing MSK injury

Cramping

Decreased grip strength & range of motion

Pain

Shaking

How should the exam table & ultrasound keyboard be adjusted?

Adjusted so the sonographer’s elbow can be positioned at a 90 degree angle

What are the most common work related injuries in sonographers?

Tendonitis & Tenosynovitis

Usually caused by repetitive stress injury

Occurs often in upper extremities (wrist), neck, lower back, cervical spine

What is Tendonitis?

Microscopic tearing of tendon

Produces inflammation & irritation in tendons

What is Tenosynovitis?

Inflammation of lining of sheath that surrounds tendon

Causes difficulty in tendon sliding through

Joint can appear locked/bent “trigger finger”

What is Bursitis?

Inflammation of bursa (small fluid sac) that cushions between tendon & bone or joint

What medications to take to help w/ pain/inflammation?

NSAID

What is Epicondylitis?

Strain on forearm muscles & tendon attachments (to humeral epicondyle)

What is Osteoarthritis?

Degenerative joint disease

Cartilage between joints break down

Chronic disease, no cure

May resort to surgery to replace joints

What is Thoracic Outlet Syndrome?

Compression of nerve & vessels in space between clavicle and 1st rib

Vascular: occurs when 1 or more SUBCLAVIAN VESSELS are compressed

Neurological: brachial plexus nerves are compressed

Causes & treatment of Thoracic Outlet Syndrome

Causes: prolonged position w/ arms held out, repetitive heavy lifting, lack of rest periods

Treatment: usually conservative (physical therapy, muscle strengthening, heat, medication)

What is your Rotator Cuff?

Group of 4 tendons that stabilize shoulder joint

Allows you to lift arms up & reach

Rotator Cuff injury diagnosis & treatment

Diagnosis: complete medical history, physical exam, Xray or MRI to diagnose

Treatment: rest, NSAID, strength/stretch exercise, ultrasound therapy, corticosteroid injection, surgery (severe)

What is Carpal Tunnel Syndrome?

Compression of median nerve at wrist

Causes numbness

Highest rate in females age 30 to 60

Cause, symptoms, and treatment for Carpal Tunnel?

Cause: repetitive motion

Symptoms: numbness, burning, muscle weakness

Treatment: splint, NSAID, steroid injection or surgery (if untreated, may cause permanent weakness, loss of sensation, or paralysis)

What is De Quervain disease?

Inflammation of tendons on thumb side of wrist (tenosynovitis)

Diagnosis based on location of pain, swelling, amount of hand function

What is Frozen shoulder?

Known as adhesive capsulitis

Stiffness & pain in shoulder joint

What is Plantar Fascitis?

Inflammation of plantar ligament

Cause: overuse of foot, aging, overweight

Symptoms: heel pain in first few steps in morning, arch pain

What is Tarsal Tunnel syndrome?

Similar to carpal tunnel

Cause: compression of posterior tibial nerve

Symptoms: occurs anywhere along path of nerve (from inside of leg to angle in foot)

How to report a work related injury?

Document & report injury to employer

Seek competent medical advice

Work w/ employer to find solutions

Common treatments for MSK injury & pain

Rest

Heat / Ice

Massage

Exercise

Protective equipment

OTC pain medication

What are intensive treatments for MSK injury?

Muscle relaxers

Steroid injections

Physical therapy

Surgery

Alternative treatments for MSK injury

Acupuncture

Acupressure

Biofeedback therapy

What are the different types of stress?

• Eustress (positive stress)

• Hyperstress (negative stress/overworked)

• Hypostress (no stress, bored)

What sources of stress are in sonography?

Ergonomic & environmental stress (ex: poor equipment, bad lighting, no space)

Workplace stress (ex: conflict, monotony)

Emotional stress (compassion fatigue, burnout)

Examples of Covid 19 healthcare work stress?

Lack of equipment (no PPE)

Overworked (pt overload, coworkers out sick)

Underappreciated

Fear for safety

Changing policies

Which pain / injury is resistant to pain meds?

Upper back & neck