Question: Has anyone any info on this growing WRULD? Sonographers are health care professionals who are increasingly at risk of neck/shoulder and arm RSI‘s little is published in this country though the US is beginning to address the problem.
Answer 1: See the RSI-UK web page, and London Hazards. (www.hazards.org). I think the typing injury faq, www.tifaq.org, has some UK stuff too: I’ll be checking that again tomorrow. I am also a member of the Sore hand List, which is the main US RSI List, so I do know how much more seriously these matters are taken there.
Answer 2: Actually, there is a bit published on this problem. I did a literature review about a year ago as part of a consulting job. I’ll send this home and see if I can come up with some notes, but it comes down to the common issues. Awkward postures (sonogram machine design, leaning over the patient, holding the transducer out and still in awkward positions (or whatever the hand-held unit is called), and doing this all day… I’ll try to dig up some specifics…
Answer 3: Below are some relevant items. I’ve forwarded to Gillian a more complete set of information that I have, but didn’t want to burden the list with it all — just a taste of issues… some of which related to other medical professions as well.
The everyday practice of Sonography can consist of the RSI risk factors of high repetition, high levels of force, awkward joint position, direct pressure, and prolonged twisted posture, such as:
- Gripping the transducer
- Applying sustained pressure
- Awkward scanning positions
- Scanning with a flexed wrist
- Scanning with a hyper extended wrist
- Maintaining a twisted posture
- Shoulder abduction
- Sustained twisting of the neck/trunk
- Repetitive twisting of the neck/trunk
- Strenuously lifting patients
- Frequent leaning over the patient
- Frequent over-stretching of the arms between the patient and the control panel
- Moving ultrasound equipment too heavy the Sonographer
- Constantly feeling rushed during a regular workday.
- Requires static and dynamic loading of the musculature of the neck, back, shoulder, and upper extremity.
The best treatment approach to MSP in Ultra Sonographers is prevention. It is important for every Sonographer to become familiar with the principles of ergonomics, and attempt to minimize musculoskeletal health hazards.
- Increased awareness of body positioning and posture should be observed.
- An educational program designed to increase the Sonographer’s awareness of the versatility of the equipment as well as the proper and improper techniques of scanning would be an effective, low cost method for reducing injury.
- Knowledge of patient placement to reduce arm abduction
- Rest arm on patient to reduce time spent holding the arm in static flexion or abduction.
- Rest arm in lap when not actively operating control panel, etc.
- Be aware of comfort level for current position
- Keep your scanning arm as close as possible to your body
- Vary the job activities performed by Sonographers so that their workday includes a number of tasks other than operating a handheld scanning device.
- Varied scanning positions.
- Alternate sitting positions from the chair to the bed beside the patient.
- Vary the types of exams performed.
- Eliminate lengthy procedures back-to-back.
- Decrease workload to a reasonable degree.
- Steady work pace and frequent rest breaks
- A min break might consist of removing the probe from the scanning hand and then stretching the hand, arm, and shoulder
- Encourage to utilize regular “micro” breaks of a few seconds possibly every 5 or 10 minutes to stretch the muscles involved.
- Specific exercise programs have been designed to counter the effects of sustained and repetitive motion injuries encountered in the workplace.
Ergonomic re-design of workplace:
- Transducers and Cables (x2)
- Control Panel/Keyboard
- Castors and Handles