Transporting Patients and Equipment
Sonographers may be required to move patients or sonography equipment to various areas of the health care facility. This may require forceful pushing or pulling of imaging equipment, patient
transport equipment (e.g., gurney, wheelchair, etc.) over differing floor materials and transitions for a significant distance.
In addition, sonographers may be required to assist patients onto and off the exam table when they arrive on any of a variety of transport devices (e.g., gurney, wheelchair, etc.). This may require
heavy lifting in an awkward body posture.
In the next two tabs, we will take a look at the potential hazards and possible solutions to help prevent injuries when transporting patients for a sonograph.
- Exerting force in awkward postures, such as bending or reaching, due to handles or push points that are too high or too low.
- Any unexpected, abrupt stoppage or deceleration when moving equipment resulting in the use of excessive force and awkward body postures. Examples include:
- wheels that are the wrong size for the transitions between flooring types or rooms
- wheels that are too small to easily pass over gaps between elevator and main floor
- obstructions placed in line of travel
- damaged floor
- debris that is left on floor increasing the amount of force exerted, often in awkward postures
- Moving equipment with wheels (casters) that are poorly maintained or are inappropriate for the flooring surface. This results in the use of excessive force and awkward body postures.
- Use smaller handheld equipment to perform bedside studies, whenever it is available and appropriate.
- Use mechanical powered assist devices whenever large or heavy patients or equipment must be moved for longer distances.
- Ensure equipment has the appropriate wheels (casters) to facilitate safe transport over all flooring and room conditions.
- Generally, wheels that have a larger diameter, a narrower width and are made of a harder material will traverse gaps and changes in flooring more easily, reducing the necessary push force.
Swivel casters should be used when maneuvering in tight locations. Note: At least one set of casters should be lockable to provide improved inline steering.
- Controls for equipment should be easily accessible without bending or reaching. These may include controls that allow selection between two-wheel, four-wheel and braked positions. Central locking is
- Aisles should be kept open and free of extraneous items such as gurneys, wheelchairs or other carts.
- Sonographers should be trained to use correct body mechanics when moving patients, wheelchairs, beds, stretchers and ultrasound equipment. Correct body mechanics suggestions may include:
- Push instead of pull. Lean slightly into the load to let your body weight assist with force exertion.
- Push at about chest height.
- Push smoothly and slowly to start.
- Do not bend or twist while exerting force.
- Keep wrists straight.
- Keep elbows close to the body.
Transferring Patients to and from the Exam Table
Sonographers may need considerable support and assistance to move patients onto or from examination tables.
- Pushing or pulling to position beds, gurneys and wheelchairs prior to transferring patients can require exertion of significant force, especially when dealing with bariatric (obese) patients,
carpeted floors or poorly maintained wheels and casters.
- Assuming awkward postures such as bending, twisting or reaching when moving patients from wheelchairs, beds or gurneys to the exam table. Awkward postures, especially when combined with the
exertion of force, increases the risk of injury to the back, shoulders, and lower and upper extremities.
- Using significant force when lifting bariatric patients from wheelchairs, beds or gurneys, increases the risk of injury to the back and shoulders.
- Use mechanical powered transfer devices such as lifts or hoists to move patients, especially bariatric or non-ambulatory, from wheelchairs, beds, or gurneys.
- When appropriate, use multi-use devices, such as chairs, that can open up into beds. These allow patients to move from a sitting position to a prone position, without transfer.
- Additional employees should assist in moving and transferring equipment or patients if:
- a mechanical powered device is not available
- awkward postures must be used
- push force exceeds about 50 pounds
- amount of weight that the sonographer must support is in excess of 40-50 pounds
Positioning Patients and Equipment
A successful sonographic scan depends on getting the transducer into an accurate position on the patient and being able to maintain that position for an appropriate period of time. Being able to
accomplish this while protecting the sonographer depends on appropriate placement of the patient in relation to the sonographer. This placement can be highly variable depending on:
- the procedure being performed
- the size of the patient and the sonographer
- the type, size, and placement of the equipment used
- the size and layout of the exam room
Songraphers must be diligent in positioning all equipment such as exam tables, chairs, lights, and carts to ensure the best possible ultrasound scan while minimizing risk to the patient and themselves.
Body Posture Concepts
Keep the body part to be scanned directly in front of the sonographer.
No matter what equipment you use or building you work in, keeping basic safe work practices in mind can help you work more safely when performing a scan. All the work items you use in your
scanning techniques should be adjusted as much as possible to ensure proper body positioning.
- Tipping the head back or forward places stress on the neck and shoulders.
- Reaching that involves pulling the elbow away from the body can stress the shoulder and back.
- Bending and twisting the torso places stress on the low back.
- Bending and twisting the lower arm and wrist places stress on the hand and elbow.
- Prolonged standing, sitting or holding the arm or neck in a static posture can fatigue the shoulder, leg, neck or hand, as well as create a contact stress on various body parts such as feet, buttocks
and the legs.
- Keep the head balanced and look straight ahead. Do not turn your head to the side or look up or down.
- Keep your shoulders relaxed. Do not hunch or raise your shoulders up during the procedure.
- Keep your torso straight. Do not bend.
- Alternate between sitting and standing positions.
- When sitting, make sure your feet, back, and buttocks are supported.
Preventing Musculoskeletal Disorders in Sonography
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