pt 2 Ergonomics and Musculoskeletal Issues in Sonography

Inflammation and the Biceps Tendon

• Inflammation can result from improper movements, such as twisting of the forearm during scans.

Occupational Injuries and Ergonomics

• Research highlights the impact of improper ergonomics in sonography, stressing the need for effective risk management strategies.

• Administrative measures aim to reduce exposure duration to potential injury risks through scheduling variation and the implementation of breaks.

Control Strategies for Injury Prevention

• Personal Protective Equipment (PPE): Considered the least effective control measure as it merely reduces exposure but does not eliminate it.

  • Example: Use of arm support devices.

• Engineering Controls: Focus on redesigning ultrasound equipment to enhance ergonomic features.

  • Key Features:

    • Height Adjustable Control Panels: Enable better reach and minimize awkward postures.

    • Transducer Design: Should be narrow enough to prevent pinch grip yet comfortable to hold.

    • Workstation Design: Includes features like electronic height-adjustable tables suitable for specific procedures.

  • Example: An examination table for cardiac views has a drop section for ease of access.

Administrative Controls

• Patient examination scheduling should avoid back-to-back similar types of exams to allow muscle recovery.

• Use of textured gloves can help prevent excessive gripping of the transducer.

• Promote mini breaks and share bedside exams to minimize strain.

Personal Control Measures

• Sonographers should be proactive in managing their body posture and equipment configuration. Key recommendations include:

  • Minimize sustained awkward postures like bending, twisting, and reaching.

  • Alternate between sitting and standing to vary muscle use.

  • Utilize arm supports to reduce shoulder strain.

  • Proper equipment adjustments based on individual size are crucial.

Gripping Techniques

• Maintain mild transducer pressure; avoid excessive gripping which can be detrimental and lead to injury.

• Lightweight transducer options and proper glove fit can significantly reduce the gripping force needed.

Wrist Management

• Keep wrists neutral when moving equipment; avoid resting wrists on surfaces during scans to prevent fatigue and injuries.

Neck Positioning

• Position ultrasound systems close to the exam table to minimize neck twisting and discomfort.

• Consider having an external monitor for patient viewing to allow sonographer and patient interaction without compromising ergonomic positions.

Scanning Arm Abduction

• Shoulder abduction should be minimized (aim for 30 degrees or less) to prevent pain.

• Patient repositioning may help reduce reaching and promote optimal scanning posture.

Cable Management

• Transducer cables can create wrist torque; using cable braces can alleviate the strain on the wrists and forearm.

Trunk Twisting

• Ensure that ultrasound equipment is arranged to minimize trunk twisting, which can lead to injuries.

• Maintain proper weight distribution and posture while scanning.

Reaching Techniques

• Controls should be positioned to minimize reaching; commonly used items should be centrally located on the control panel.

• Adjust positioning for comfort, ensuring legroom under the control panel allows for ease of movement.

Importance of Exercise

• Regular exercise aimed at strengthening and stretching the upper body can mitigate risks of injury due to repetitive motions in sonography.

Economic Implications of Ergonomics

• Occupational injuries have significant economic impacts on both employers and employees, including:

  • High costs associated with workers' compensation and loss of productivity.

  • Direct costs: $60 billion annually; indirect costs can reach $150 billion.

Setup of the Workstation

• An appropriately designed ultrasound room allows for flexible configurations to enhance ergonomic positioning.

• The room should facilitate easy movement of equipment and accommodate different sonographers throughout the day.

Key Pearls of Ergonomic Practice

• Understand that WRMSDs are injuries resulting from workplace ergonomics. Employ best practices to mitigate these risks.

• Adjusting workstations to fit individual needs can significantly improve productivity and reduce injury risk.

• Awareness and prompt adjustments to posture and technique can greatly aid in injury prevention.