Engineering, Administrative, and Work Practice Controls
In the day-to-day operations of a sonography lab, there is always pressure to increase the number of procedures performed. To reduce the risk of potentially career-ending MSDs, management should ensure
the need to perform a high number of procedures does not compromise management commitment to implementing proper ergonomic measures for sonographers.
When your employer does not make safety a priority in your workplace, the institution can experience the following costs:
- excessive sick leave absences
- reduced production
- loss of workforce
- costs related to temporary staff
- all other costs associated with recruiting and training for a hard-to-fill position
On average, if today's sonographers have been scanning for more than 10 years, their training did not include instruction on occupational injury and how to avoid it. Recognition of the problems
and possible interventions can help sonographers protect themselves by identifying and avoiding hazardous situations.
Problem Recognition and Intervention
Many sonographers operate with relative independence. It is necessary they remain informed about the possible hazards associated with the procedures they are performing. They should use all controls
available to minimize the intensity and time they are exposed to stressful procedures.
Employers should ensure sonographers receive appropriate training and follow best practices in order to reduce the risk of developing MSDs. These best practices include:
- Take time to adjust all available equipment to minimize periods of the following:
- sustained bending
- contact pressure and awkward postures
- alternating between sitting and standing positions
- varying scanning techniques and transducer grips
- Reducing arm abduction (spread) and forward and backward reach by using measures such as:
- requesting the patient move to a position which is advantageous from a posture standpoint, usually as close to you as possible
- adjusting the exam table and chair
- using arm supports
Problem Recognition and Intervention (Continued)
- Lower the light level in the room to eliminate glare on the monitor and to increase contrast on the monitor so the image can be seen comfortably and without strain.
- Relax muscles periodically throughout the day:
- Stretch hand, shoulder, and back muscles.
- Take mini breaks during the procedure.
- Refocus eyes onto distant objects.
- Vary procedures and tasks as much as reasonably possible.
- Take meal breaks away from work-related tasks.
- Maintain a high level of physical fitness and range of motion in order to perform the demanding work tasks that are required. Spend a few minutes warming up muscles prior to undertaking tasks.
Employers should ensure that sonographers participate in education and training to reduce the risk of developing musculoskeletal disorders. This education and training could include:
- attending employer sponsored in-services
- attending seminars, lectures, workshops or conferences offered by professional organizations or manufacturers
- accessing journals, textbooks or online resources
- attending a formal sonography program which includes education on MSDs prevention in the curriculum
Engineering Controls, Work Practices and Scheduling
There are several factors that may increase the force, posture, or repetition of a task which may result in injuries.
- locating equipment in a room that is too small to allow for proper arrangement and alignment of the machine, bed, chair and sonographer
- inadequate ventilation
- lighting that is too bright and unable to be controlled
- poor orientation of diagnostic suites in relation to other critical areas requiring excessive frequency and distance of equipment or patient transfer
- lack of time to properly adjust equipment or patients for optimal procedure performance
- lack of knowledge about how to design, setup and equip the diagnostic suite for a particular procedure
- Provide adequate space in the examination area for the maneuverability of equipment around the exam table and easy access from all sides.
- Provide adjustable room lighting with easily accessible dimmer controls and/or window shades or curtains.
- Provide adequate ventilation and temperature control to ensure the comfort of sonographer and patient while enabling the equipment to operate at a functional temperature.
- New equipment should always be assessed for its suitability in the physical space in which it will be used.
- Provide adequate rest breaks between examinations, particularly for challenging procedures which are comprised of similar postural and muscular force requirements.
- Provide annual training to all employees on the risk and prevention of musculoskeletal disorders.
- When planning to purchase new equipment, the employer should seek the input of technical staff to assess the risks and suitability of the equipment. For example, at least some tables should be able to accommodate bariatric (obese) patients weighing up to 600 pounds.
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