1. Ergonomics for Sonographers An owner’s manual
hhholdorf

2. Ergonomic Guidelines for Sonographers
CHECKLIST
Managing Work Injury Prevention in Sonography
The Importance of Ergonomics in Diagnostic Ultrasound
Setting up the Ergonomic Work Station
Sonographer Work Related Injuries
The Economics of Ergonomics for Sonography
The Importance of Exercise and Fitness In the Prevention of WRMSDs
Reducing Muscle Fatigue & Load Through Postural Changes
Making it Ergonomically Right with What You Have
Taking Responsibility for How you Practice
Reducing Your Risk of Occupational Injury

4. Happy, happy, joy, joy!!

5. Ergonomics You’re doing it wrong.

6. Fuzzy wrong.

7. The injury risk factors impacted by chair selection are…
Increased spinal pressure
Unsupported feet
Decreased circulation of lower extremities

9. The study of ergonomics involves adapting the work environment to the worker, NOT adapting the worker to the work environment.

10. Data collected from around the world shows that over 80% of sonographers have some degree of pain or injury related to their work as a sonographer. Of these individuals, 20 percent have sustained a career-ending injury.

11. Sonographers at the highest risk for developing MSD (musculoskeletal Disease) are those who perform the same type of exams during the work day.

12. Engineering controls:
The name for ergonomic controls that remove or reduce the presence of risk factors in the work place.

13. Once your patient is lying on the exam table, ask her to move toward you and close to the edge of the table. Adjust the height of the table and chair so that your forearm is PARALLE to the floor when your elbow is bent at a 90-degree angle.

14. Cardiac sonographers…beware!!

15. Symptoms of MSD can occur after months or years of overuse and have been staged according to the reversibility and outcome of the symptoms.
There are Three stages of pain: Stage 1, Stage 2, and Stage 3.
Aching, fatigue and weakness, as well as pain, describes Stage 1.

16. Specific disorders of MSD common among sonographers are:
Tendonitis
Thoracic outlet syndrome
De Quervain’s Syndrome
Tendonitis of the sheath that surrounds the two tendons that control movement of the thumb.

17. The cost to the employer of WRMSD (work-related musculoskeletal disorder) is significant. Of all the costs associated with WRMSD, Worker’s Compensation is the most costly.
Other costs-Replacement staff…

18. It takes more than one…
Employers, Sonographers, and Equipment Manufactures can contribute to a reduction in WRMSD in Sonography.

19. Treatment for WRMSD has a poor outcome because sonographers return to the same injury-producing environment*.
*without modification.

20. In addition, many leisure activities can cause MSD:
Gardening
Knitting
Playing the violin
Texting?
HINT: What to be published in the JDMS?
Run a study on texting and how it relates/does not relate to MSD. GET A GRANT TO FUND THIS STUDY!!

21. Add-on patients are best accommodated during lunch breaks so that the workday does not exceed 8 hours.
NOT!!!
Give yourself a chance to rest.

22. The term “ergonomics” was created by W. Jastrezebowski in the 1800’s.
The International Ergonomics Association defines ergonomics as follows:
“Ergonomics is the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data and methods to design in order to optimize human well-being and overall system performance.”

23. The SDMS (Society of Diagnostic Medical Sonography) has sponsored several activities that addresses ergonomics:
Sonographer Benchmark Survey
The 1997 sonographer survey by the Healthcare Benefit Trust of British Columbia
The consensus conference in May of 2003

24. The phases of ergonomic intervention in the workplace include:
Analysis of the worker’s job tasks
Proposing possible solutions to mitigate worker injury
Regular evaluation of the effectiveness of solutions

25. The OSHA (Occupational Safety and Health Administration) regulation that addresses Sonography work environments is the General Duty Clause.
“Each employer shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees.”

26. Changing a Sonographer’s work schedule is an example of an Administrative control measure.

27. Ergonomic training is an example of a control measure called SONOGRAPHER SOLUTIONS.

28. Best practices for sonographers:
Adjusting chairs & exam tables
Positioning patient close to worker
Supporting scanning arm
Performing regular stretching exercises
STUDENTS!!!
SEE NEXT SLIDE

30. A key factor that contributes to a worker’s risk for MSDs is STRESS.
Factors that may reduce a worker’s risk for MSDs are:
Stretching
Employer support
Relaxation

31. Excessive trunk bending and twisting can be prevented by
Moving the patient close to the worker
Adjusting the exam table height

32. The ideal maximum angle of arm abduction for the majority of work tasks is 30 degrees.

33. Prolonged sitting results in Muscle shortening.

34. Extreme and prolonged arm abduction is injury producing because:
It decreases circulation to the shoulder joint.

35. When sitting for prolonged periods of time, movement is important for
Maintaining hip flexibility
Strengthening back muscles
Strengthening abdominal muscles

36. Studies measuring force exerted by sonographers during an exam show that force can be as high as 40 lbs.

37. One way to reduced risk for injury resulting from bedside exams is to perform exams portably only when absolutely necessary.

38. A more comfortable position for the Sonographer's scanning arm during endovaginal exams is with forearm below shoulder level

39. Resting your non-scanning arm on the ultrasound system: Results in pressure on the carpal tunnel

40. Exam gloves can contribute to injury risk unless:
They fit properly
They have textured finger

41. The most injury producing method of gripping the transducer is the Pinch grip.

42. Examples of the direct costs associated with worker injury are:
An example of the indirect costs associated with worker injury is the cost of hiring replacement staff.
Examples of the direct costs associated with worker injury are:
Cost for rotator cuff surgery
Worker’s Compensation insurance

43. The main goal of ergonomics is to increase productivity.

44. The ergonomic benefit of retractable side rails on the exam table is to:
Reduce the distance between the sonographer & the patient.

45. An important dietary component for maintaining muscle tone is Vitamin B

46. Upper body stability can be achieved by good foot support.

47. Collectively, MSDs (or MSIs: Musculoskeletal Injuries) are defined as Injuries caused by work activities.

48. The economic impact of worker injury is
Loss of experienced workers
Loss of productivity
Personal financial hardship

49. Exercise helps mitigate injury by developing the muscles that support neutral postures

50. Tendon injuries have an impact on the surrounding muscles.
The Muscle must compensate by providing increased support for the joint, which can lead to further injury.

51. Musculoskeletal pain can be caused by damage to:
Bones and joints,
Muscles, and tendons,
Ligaments, nerves and bursae

52. Keep on the lookout…
Early symptoms of WRMSK may occur at night causing disruption of sleep

53. The components of the ultrasound work station are:
Ancillary equipment
Personal adaptive equipment
Ultrasound system

54. Get this table…not!! Too Expensive…

55. Cushions for forearm support, cable brace are considered to be adaptive equipment.

56. The following features are essential for an ergonomic multipurpose ultrasound table:
Electrically height adjustment
retractable side rails
stirrups
brakes

57. The major four sites of injury for the Sonographer are:
Shoulder,
neck
wrist
Upper back

58. The most ergonomic work station would have the following:
Table height adjustable from inches,
Chair height adjustable from inches.
Ultrasound system with monitor separately adjustable from the control panel.

59. Muscle activity be reduced by supporting the forearm on cushions or towels by as much as 78%.

60. Question: “How many scans is it ‘safe’ to do per day?”
Answer: “It is not how many exams you can do, but how you scan that reduces your risk.”