Ergonomics

Worker awareness, unwillingness to work in pain, busy patient schedules, job dissatisfaction, ageing workforce, computerization of the workplace

Factors that contribute to reported injury rates:

movements that promote normal muscle contraction and relaxation

Human physiologic functioning depends on:

epicondylitis (lateral and medial)

Inflammation of the periosteum in the area of the insertion of the biceps tendon into the distal humerus. Can result from repeated twisting of the forearm

Tendonitis/Tenosynovitis

Inflammation of the tendon and the sheath around the tendon, which often occur together.

90

More than _______% of sonographers have some form of MSDs that can be attributed to their work activities

International ultrasound industry consensus conference

Organized in May, 2003 and is hosted by the SDMS (Society for Diagnostic Medical Sonography), and its goal is to develop injury risk-reducing standards to address the problem of WRMSDs in sonography

intermediate stage of WRMSD symptoms

aching and tiredness occur early in the work shift and persist at night. Reduced capacity for repetitive work

early stage of WRMSD symptoms

aching and tiredness of the affected limb occurs during the work shift but disappear at night and during days off work. no reduction of work performance

late stage of WRMSD symptoms

aching, fatigue, and weakness persist at rest, inability to sleep and perform light duties

Specific points addressed by the international ultrasound industry consensus conference

addressed the issues of workload, scheduling, and room size. discussed best practices, education, and training. discussed the need for accredited programs to include curriculum related to ergonomics and injury prevention and the need for certifying bodies to test knowledge of risk factors

height

adjust __________ of the table, bed, or chair when needed.

Neutral scanning posture

adjust equipment and patient positions. position the ultrasound system parallel to exam table with no space in between. adjust monitor so top is at eye level and screen is directly in front of sonographer. adjust system control panel to minimize reach. adjust exam table height to minimize abduction of scanning arm. adjust chair height, and position patient to nearest edge of table

backward

avoid forward and __________ reach.

Transducers of an Ultrasound system

cables should be thin, flexible, and lightweight; the cable should be supported during an examination and the it should be easy to activate with readily accessible connecting ports and storage.

nerve entrapment syndrome

caused by increased muscle and tendon pressure on major nerves that run behind tightened muscles. Tasks that require the worker to lean forward continually or to bend the head down or laterally are examples of these types of postures

bedside examinations

ensure that the ultrasound system can be moved and has a small footprints. try to share these type of examinations with other hospital staff, do not take up the whole room. should be reserved for those patients whose conditions prohibits transporting them.

carpal tunnel

entrapment of the median nerve as it runs through the carpal bones of the wrist. results from repeated flexion and extension of the wrist and also develops from mechanical pressure against the wrist.

cubital tunnel

entrapment of the ulnar nerve as it runs through the elbow. can result from repeated twisting of the forearm and mechanical pressure against the elbow as it rests on the examination table during scanning

20-20-20 rule

every 20 minutes, take 20 seconds to look away from your screen and at something 20 feet away from you

Alliance program

helps organizations work with OSHA to prevent workplace injuries by education and leading employers and their employees in advancing workplace safety and health

trigger finger

inflammation and swelling of the tendon sheath in a finger entraps the tendon and restricts motion of the finger. also a result from the "pinch" grip

bursitis

inflammation of the shoulder bursa from repeated motion

close

instruct the patient to move as __________ to you as possible

spinal degeneration

intervertebral disc degeneration that results from awkward and static postures, bending, and twisting while scanning

Engineering solutions to work-related injury prevention

involves a change in the physical features of a workplace. are the preferred methods for control because they can effectively eliminate workplace hazards. tend to be the most expensive initially

Administration solution to work-related injury prevention

involves workplace policies, changes in patient scheduling and sonographer rotations, and the implementation of rest breaks. control and lessen the duration and frequency of exposure to any injury risk

Personal Protective Equipment (PPE)

it is promoted and addresses the best practices and the use of arm support devices. although sonographers are still exposed to the risk factor, the exposure is somewhat reduced. Least effective control

shoulder pain

most common complaint for a sonographer. involves the sonographer's scanning arm

Thoracic Outlet Syndrome

nerve entrapment can occur at different levels, resulting in a variety of symptoms. to prevent this have no more than a 30 degree abducted (from midline) angle when scanning

soft tissues, spine

prolonged static postures, whether sitting or standing, increases the load on _______________ and the compressive forces on the __________.

rotator cuff injury

repeated motion, which causes fraying of the rotator cuff muscle tendons. this injury increases with age and is even more prevalent when work-related stresses are added. repeated arm abduction contributes to this injury by restricting blood flow to the soft tissues of the shoulder

Administrative controls

schedule patient examinations to prevent the repetition of the same type of examination back to back. have sonographers perform a variety of examinations, allowing different muscle to fire. design the schedule to allow enough time between examinations for muscle recovery. examination gloves should have textured fingers to prevent the need to grip the transducer too tightly and it is recommended that sonographers take short "mini" breaks during examinations to relax muscles, especially in the should and neck

Ultrasound systems

should be easily mobile and have brakes, control panel should be height adjustable and swivel, and monitor should also be height adjustable, independent of the control panel and able to turn and tilt. controls should be easy to access without overreaching and transducers should be neither too wide or too narrow. Transducer cables should be thin, flexible, and lightweight; the transducer cable should be supported during an examination and the transducer should be easy to activate with readily accessible connecting ports and storage.

Proper posture when sitting

sonographer sits up straight with the top of the monitor at level the eyes and an arm's length away. the feet are supported on the ring of the chair, and the forearm is supported on a cushion

Examination room and additional support

sonographers should be able to support their arms while scanning. the room should be large enough to allow for a flexible set-up and must have appropriate lighting to reduce the glare on the monitor and subsequent eye strain

De Quervain's Disease

specific type of tendonitis of the thumb that can result from gripping the transducer too tightly

separate

take meal breaks ________ from work-related tasks

Occupational safety and health administration (OSHA)

the occupational safety and health act is administered by ______________, an agency of the US department of labor

Ergonomics

the study of the human body at work. the primary goal is to increase productivity while decreasing worker injury. this goal is accomplished by modifying products, tasks, and work environment

the purpose of the occupational safety and health act

to ensure, as far as possible, that every working man and woman in the nation has safe and healthful working conditions

large, small

use ___________ muscles before using ___________ muscles

whole hand (palmer)

using a ________________ grip rather than a pinch grip on a transducer uses larger hand muscles rather than smaller finger muscles

Muscles activity

what aids in the circulation of blood, allowing nutrients to be carried to and toxins to be removed from the muscles.

awkward and static postures

what can cause muscles to be contracted continuously, therefore they cannot receive oxygen or get rid of toxins.

repeatedly rotating the head, neck, and trunk

what can cause one set of muscles to become stronger and shorter and the opposing muscles to become weaker and elongated

1970

when did congress pass the federal occupational safety and health act?

guideline for work-related injuries reporting with OSHA

work-related injuries must be reported immediately to occupational health or risk management departments, injuries should be recorded on OSHA logs, or else risk denial of claims

Ultrasound examinations

All _______________ involve repetitive motion that can cause WRMSD

Result in restricted work, or days away from work. they involve MSD symptoms that remain for 7 or more days and require medical treatment beyond first aid.

WRMSD incidents are defined as injuries that:

long-term, 60

WRMSD is the main reason for ______________ absences among health care workers and account for _________% of all workplace illnesses

asymetric

When a ___________ force is exerted on the spine, misalignment of the spine occurs

pushing, pulling

____________ rather than _____________ uses large gluteal and hamstring muscles in legs rather than small muscles of arms and back

Asymmetric forces

_________________ are exerted on the spine when more weight is placed on one side of the body than the other. the head must be turned to view the monitor resulting in a twisted neck.

Work-related musculoskeletal disorders (WRMSDs)

AKA: musculoskeletal disorders (MSDs), musculoskeletal strain injuries (MSIs), Cumulative trauma disorders (CTDs). They are painful conditions caused by or aggravated by workplace activities. It can affect muscles, nerves, ligaments, and tendons

1980

Awareness of pain and discomfort associated with the occupation of sonography surfaced around __________, just before the widespread use of real-time scanners.

50

Contraction of more than ________% of the body's muscles is required to maintain static postures.

forceful exertions, awkward postures and prolonged static postures, repetitive motions, "pinch" grip, environmental factors such as extreme hear, cold, humidity, or vibrations

Risks factors for WRMSD in sonography

imbalances between the muscles that move and the muscles that stabilize

Sustained awkward postures can cause: