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Musculoskeletal Injuries

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Musculoskeletal Injuries & Scanning Ergonomics in Sonography Anna Clifton, Gema Lambert and Jennifer Metts ... – PowerPoint PPT presentation

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Title: Musculoskeletal Injuries


1
  • Musculoskeletal Injuries Scanning Ergonomics in
    Sonography
  • Anna Clifton, Gema Lambert and Jennifer Metts

2
Musculoskeletal Injury Facts
  • In the field of sonography, musculoskeletal
    injuries affect approximately 80 of the
    workforce.
  • One of every five sonographers (20) is affected
    by a career ending injury.
  • The average time a sonographer is working in the
    profession before experiencing pain is
    approximately five years.
  • Many sonographers do not report their pain
    because the feel nothing can be done to improve
    the situation.

3
Musculoskeletal Injury Terms
  • Musculoskeletal injuries among sonographers have
    been described with many terms
  • Work-Related Musculoskeletal Disorder (WRMSD)
  • Musculoskeletal Disorder (MSD)
  • Musculoskeletal Injury (MSI)
  • Repetitive Strain Injury (RSI)
  • Cumulative Trauma Disorder (CTD)

4
Physical Demands
  • Sonographers must have full use of hands, wrists,
    and shoulders and they face many physical demands
    such as the following
  • Lift more than 30 pounds
  • Push and pull
  • Bend and stoop
  • Work standing on their feet at least 80 of the
    time
  • Assist patients on and off examining tables

5
Risk Factors
  • Three primary risk factors that contribute to
    WRMSD
  • Posture
  • Force
  • Repetition

www.back-pain.management-relief.com
6
Description of Exposure
  • Repetitive motion
  • Forceful and awkward movements
  • Persistent continual pressure for long durations
  • Poor posture and body mechanics
  • Improper positioning
  • Excessive force and strain
  • Increased exam scheduling

7
Causes of WRMSD
  • How does a musculoskeletal injury occur?
  • Basically, thousands of forceful, awkward and
    repetitive movements eventually produce trauma to
    muscles, tendons and ligaments which leads to
    pain, inflammation, swelling and deterioration of
    tendons and ligaments.

www.bahdy.com
8
Common Work-Related Injuries To Sonographers
  • Shoulder (Rotator Cuff)
  • Elbow
  • Neck
  • Lower Back Pain
  • Wrist Pain

www.cepu.ash.au
9
Anatomical Sites of Discomfort
Eyes 45
Neck 74
Upper Back 58
Shoulder 76
Upper Arm 38
Middle Back 33
Forearm 31
Low Back 58
Hip 25
Wrist 59
Hand/Fingers 55
Upper Leg 7
Knee 17
Lower Leg 12
Ankle/Foot 20
Illustration re-created information provided
by www.sdms.org/pdf/sonoergonomics.pdf
10
Symptoms
  • Pain
  • Clumsiness
  • Numbness
  • Burning or tingling
  • Tenderness
  • Swelling
  • Loss of sensation
  • Loss of function
  • Muscle spasm
  • Muscle Weakness

www.superaloe.com
11
Tasks That Aggravate Musculoskeletal Symptoms
  • Applying pressure with the transducer
  • Shoulder abduction
  • Sustained twisting of the neck trunk
  • Repetitive twisting of the neck trunk
  • Performing portable exams

12
Consequences of WRMSD
  • Decreased and painful work activities
  • Decreased and painful home activities
  • Decreased and painful recreation activities
  • Absent from work
  • Redesign of work station
  • Specialized equipment
  • Fewer work hours
  • Change in profession
  • Physical disability

13
Raising Awareness
  • Often, the risk for WRMSD is not the result of
    the work be performed, but rather how it is being
    performed.
  • By increasing awareness of ergonomics, current
    and future sonographers can learn preventative
    measures associated with work-related injuries.

14
Scanning Ergonomics
  • Sowhat are ergonomics?
  • In general, ergonomics is the science or study of
    how people are affected by their work
    environment.
  • Ergonomics help adapt and adjust products, tasks
    and environments to people to help reduce
    musculoskeletal disorders and workplace injuries.
  • The most effective control measures to help
    prevent WRMSD include sonographer work methods
    and changes in workstations.

www.safetyworld.com
15
Prevention
  • Prevention of WRMSD requires a combination of
    changes involving sonographers, department
    managers and equipment manufacturers.

www.spectrumtherapy.com
16
Recommendations To Reduce Risk
  • Recommendations to reduce risk should include the
    following
  • Engineering controls - proper equipment and
    workstation design and layout
  • Administrative controls work organization and
    work practices
  • Individual controls risk identification and
    control, training and education

17
Sonographer Awareness
  • Sonographers should learn the following
  • Be aware of activities that cause pain and learn
    to modify those activities.
  • Learn the proper use of all exam room equipment.
  • Utilize adaptive equipment when scanning, such as
    support cushions.
  • Learn to perform stretching and strengthening
    exercises designed to prevent injury.

18
Sonographer Work Practices
  • Decrease the duration of static posturing by
    varying postures throughout the day.
  • Decrease hand grip pressure loosen grip on the
    transducer, take short breaks, vary grip used on
    the transducer.

19
Sonographer Work Practices
  • Minimize awkward and extreme postures.
  • Increase muscle tissue strength and tolerance to
    injury through exercise and adequate rest.
    Minimize awkward and extreme postures.
  • Increase muscle tissue strength and tolerance to
    injury through exercise and adequate rest.

20
Musculoskeletal Checklist
  • Is the patient close enough to me? Is my arm and
    elbow tucked in closely to my body in a
    comfortable position.
  • Did I adjust my chair or examination bed
    according to the body habitus of my patient in
    relationship to my height.
  • Is my posture a comfortable and correct so as not
    to cause stress on my body?
  • Am I working with my wrist and neck in a straight
    and supported position?
  • Is the monitor and keyboard positioned so that I
    can easily see and reach them?
  • Am I supporting my limbs properly throughout the
    entire examination?
  • When I stand, am I carrying my body weight
    equally on both feet?
  • Did I take a short break? Did I consciously
    release tension on the scanning hand for a few
    seconds?
  • Did I take a longer break? Did I remove the
    probe from the scanning hand, stretching the
    hand, arm and shoulders.
  • Am I aware of any unusual symptoms, such as
    numbness, swelling or pain?

21
Musculoskeletal and Physical Affects From
Transducer Use
3D/4D OB Transducer
2D OB Transducer
22
Musculoskeletal and Physical Affects From
Transducer Use
Heavy, inflexible transducer cables put
additional strain on the wrist, forearm and elbow
of the scanning arm requiring increased grip
force to resist the torque created by the
transducer cable.
23
Musculoskeletal and Physical Affects From
Transducer UseMs Jeri GrayCentral Georgia
Perinatal Associates
24
Interview with Renee Delzeith Winn Army
Hospital June 27, 2008
25
Interview with Renee Delzeith Winn Army
Hospital June 27, 2008
26
Interview with Renee Delzeith Winn Army Hospital
June 27, 2008
27
References
  • Baker, J. Murphey, S. Ultrasound ergonomics.
    Sound Ergonomics, 1-2.
  • Batchelor, J. (2000, August 17). Employers can
    reduce repetitive strain injuries among
    sonographers. Retrieved on May 20,2008 from
    http// www.auntminnie.com.
  • Biosound Esaote. (2002). The value of
    ergonomically designed ultrasound systems.
    Murphey, S. Coffin, C.
  • David, S. (2005). Importance of sonographers
    reporting work-related musculoskeletal injury A
    qualitative view. Journal of Diagnostic Medical
    Sonography, 21(3), 234-237.
  • Epp, R. (2006, September). Preventing
    work-related musculoskeletal disorders in
    sonography. National Institute for Occupational
    Safety and Health, 148, 1-4.
  • Environment of Care. (2006, March). Preventing
    occupational injury among diagnostic medical
    sonographers. Joint Commission on Accreditation
    of Healthcare Organizations, 9(3) 6-7.
  • Murphey, S. (2008, April 30). Lean principles and
    ergonomics aid imaging management. Retrieved May
    20, 2008 from http//www.auntminnie.com.
  • Murphey, S. Coffin, C. (2002, August).
    Ergonomics and sonographer well-being in
    practice. Sound Ergonomics, Article 102-sp-1046.
    Retrieved July 7, 2008, from www.healthpronet.wj/
    images/articlesound.
  • Murphey, S. Milkowski, A. (2006). Surface EMG
    evaluation of sonographer scanning postures.
    Journal of Diagnostic Medical Sonography, 22(5),
    298-305.
  • Employee Health and Safety Services. (2000,
    July). An update on ergonomic issues in
    sonography Murphy, C. Russo, A.
  • Sound Ergonomics Biodex Medical Systems.
    (1998). Sonographer occupational muculoskeletal
    disorders What are they and how can they be
    prevented.
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