Chapter 4: Sonographer Safety Issues Flashcards
By the beginning of the 21st century, how many SGs reported scanning in pain?
More than 75%
How many SGs experience career-ending injury?
1 in 4
What causes a SG injury?
i. Poor conditions
ii. Lack of ergonomic importance
MSI stands for?
Musculoskeletal Injury
MSIs result from…
miniscule cumulative trauma causing the breakdown of tissue due to a combination of biologic and biomechanical factors.
The most common work-related injuries among SGs are…
tendonitis and tenosynovitis of the shoulder, neck, wrist, and back.
RSI stands for?
Repetitive strain injuries
RSIs are directly related to…
prolonged periods of arm abduction and muscle loading along with the constant transducer pressure during scanning.
RSIs are caused by
i. Use of poorly designed equipment and stretchers
ii. Improper body mechanics while scanning
iii. Procedure duration
iv. Inappropriate force
v. Insufficient rest breaks
vi. Repetition of the same type of study for long periods during the workday
Lower back pain is commonly caused by…
by sitting/standing for long periods.
To fix lower back pain
correct posture, relax musculoskeletal structures, take short breaks
Upper back and neck pain is commonly caused by…
repetitive strain on muscles and ligaments due to poor, awkward, or static posture.
To fix upper back and neck pain
adjust the monitor and position patient’s properly
Shoulder pain is commonly caused by…
the abduction of the arm >30% and by repetitive, excessive, or static force; causes bursitis
To fix shoulder pain
position patients close to the edge of the table to narrow the reaching area and lessen arm abduction; the SG’s elbow should be a 90 degree angle.
Pain in the upper extremities (wrist and hands) is commonly caused by…
the use of poorly designed transducers and excessive grip; causes tendonitis, tenosynovitis, and tunnel syndromes
Lack of tendon elasticity and constant pulling on the tendon attachments results in
low-level tearing and inflammation
Symptoms of upper extremities pain
range from aching or burning sensation to pain and stiffness
To fix upper extremeties pain
stretch, wear a cable brace
Digital Tendonitis and tenosynovitis is…
Tendon sheath inflammation that keeps the tendon from gliding smoothly within the sheath resulting in flexor digital tenosynovitis aka trigger finger
Symptoms of digital tendonitis and tenosynovitis (trigger finger)
Finger locks as it extends with a ‘snap’; aching or pain at the wrist and thumb which is aggravated by motion; often goes hand in hand with carpal tunnel syndrome
To fix digital tendonitis and tenosynovitis
Rest, warm soaks, NSAIDs, corticosteroid injections
Carpal tunnel syndrome is the most common…
nerve entrapment; this RSI is more common in females 30-60
Carpal tunnel syndrome is caused by…
compression of the median nerve
Symptoms of carpal tunnel syndrome
Numbness, burning, or tingling sensations in the hand, thumb, or fingers and possible shooting pain to the upper arms and down the fingers
The carpal tunnel is…
A narrow passageway on the palm side of the wrist bounded by bones and ligaments; protects the median nerve to the hand and nine tendons that bend the fingers.
To fix carpal tunnel syndrome
do muscle/nerve conduction tests, splints, NSAIDs, steroid injection, surgery, use ergonomically safe equipment, proper body mechanics and take breaks between exams
Carpal tunnel surgery is…
when the carpal ligament is excised releasing pressure on the median nerve
Prognosis of carpal tunnel syndrome
muscle weakness/atrophy of the effected hand, possible loss of sensation or paralysis of the affected part if left untreated, may result in permanent disability if left untreated
De Quervain disease is…
A painful inflammation of specific tendons of the thumb. The swollen tendons and their coverings cause friction within the narrow tunnel of sheath through which they pass. The result is pain just below the base of the thumb; one of the most common types of tendon lining inflammation.
Symptoms of de Quervain disease
localized tenderness and swelling of the styloid process of the radias; may decrease the range of motion of the lower joint of the thumb and crackling noises are heard over the tendon when it is moving
The Finkelstein test is…
to make a fist with your thumb inside on your palm and bend wrists outside
To fix de Quervain disease
hot/cold applications, NSAIDs, controlled exercise to prevent frozen shoulder, steroid injections in the tendon sheath, surgery
A neuroma is
a mass or tumor on a nerve; a disabling complication of de quervain surgery
The fascia is…
the broad flat ligament on the bottom of the foot that extends from the front of the heel to the base of the toes and helps maintain the arch of the foot
Plantar fasciitis is caused by…
activities that increase weight/stress when working on hard floors or ground, normal aging, being overweight
Symptoms of plantar fasciitis
mild debilitating pain with the first few steps in the morning, often confused with heel spur
Prevention of plantar fasciitis
wear shoes with good arch support and cushioning that are flexible enough to bend under the ball of your foot
Treatment of plantar fasciitis
rest, ice, taping, exercises, orthotic devises, shock wave therapy, surgery
Tarsal tunnel syndrome is caused by…
pressure on/compression of the posterior tibial nerve related to standing for long periods of time
The tarsal tunnel is…
a structure in the foot formed between the bones of the foot and the overlying fibrous tissue where the posterior tibial nerve lies
Symptoms of tarsal tunnel syndrome
painful burning, numbness, or tingling around the inside of the ankles
Treatment of tarsal tunnel syndrome
NSAIDs, orthotics, change in footwear, steroid injections around the nerve, surgery
SG’s checklist for preventing work-related pain
i. Be in good physical condition
ii. Follow ergonomic principles
iii. Safe body mechanics
iv. Rest
v. Correct unsound work habits, like posture
vi. Correct unsound ergonomic aspects in the workplace
Areas of workplace stress
i. ergonomic stress
ii. environmental stress
iii. air quality
iv. overcrowding
Sources of ergonomic stress
imaging equipment, patient exam tables and SGs chairs should be designed with max flexibility, height adjustability, and proper support
Tips for eye strain
- avoid high ambient/fluorescent lighting to reduce glare and eye strain
- use a dimmer switch
- position the u/s machine parallel to the windows to prevent screen glare
- should have dark walls and carpeting to absorb excess light
- get routine eye exams
- position the top the monitor at eye level; look downward at the screen
Presbyopia
older SGs find it difficult to focus on the display screen; affects almost everyone over 45
The 20-20 rule is..
OSHA recommends 10 min rest breaks for every 2 hrs scaning
OSHA stands for…
occupational safety & health administration
Modern buildings suffer from poor air quality due to
steel and concrete construction, sealed windows and HACV
Ideal negative ion concentration
2000-4000 negative ions per cubic cm
Common negative ion concentration
25-50 negative ions per cubic cm (mostly from fluorescent lights)
Negative ions do what?
Attach themselves to airborne particles like dust, smoke and pollution which become heavy and fall to the ground
Ozone is…
a product of negative ionization, oxides and neutralizes harmful aspects of the chemicals that make up pollution, acting as a powerful germicide, destroying mold and fungus
Negative air ionizers
traditionally employed on submarines and other sealed environments, proven to improve disease resistance
Overcrowding
Most severe in intensive care units and emergency departments; tight quarters = poor posture
Solutions to overcrowding
- Examine the problem
- Search for realistic solutions
- Evaluate goals
- Discard any that are unrealistic
Internally generated stress is…
Stress we cause ourselves that ends up provoking burnout and compassion fatigue
Short term stress
i. Insufficient patient load contributes to boredom, lack of concentration, and motivation
ii. Feelings dissipate when the patient load picks up
Long term stress
i. Encourages frustration, irritation, and fatigue
ii. Can result in feelings of failure, increased absenteeism, distancing oneself from coworkers and resigning; leads to burnout and compassion fatigue
Burnout is…
a state of mental exhaustion caused by excessive or prolonged stress, working in abusive environments and being unable to change it; seen especially in ‘helping’ professions
Strategies to cope with burnout
- Sufficient rest
- Regular exercise
- Talk to coworkers/friends
- Learn to say ‘no’
- Indulge in a special treat
Symptoms of compassion fatigue
a lessening or loss of sympathy for the misfortunes of others, prevalent in overextended individuals who assume to much responsibility; may become emotionally detached
Treatment for compassion fatigue
- Inspect your true motivations
- Learn to empathize without absorbing the patient’s pain
- Talk about your feelings with friends or possibly get professional help
Compassion fatigue cure
realize your primary need to take care of yourself and make serious changes to your life; awareness is the key to coping with any kind of stress
Ergonomics is… (Jennifer’s definition)
The study of the problems of people adjusting to their work environment, which seeks to adapt work or working conditions to suit the worker. The creation of a safe working environment.
Ergonomics is… (textbook definition)
the science of work. Removes barriers to quality, productivity, and safe human performance by fitting products, tasks, and environments to people
Definition of Musculoskeletal injuries (MSIs)
injuries to the muscles, nerves, tendons, ligaments, joints, cartilage, and spinal disk due to physical work activities or workplace conditions. Also known as musculoskeletal disorders (MSDs) or work-related musculoskeletal disorders (WRMSDs).
Nonsteroidal antiinflammatory drugs (NSAIDs)
special class of drugs that reduce inflammation and relieve pain
Definition of Repetitive strain injuries (RSIs)
tendon and nerve disorders resulting from many repeated, strong wrist motions. Also known as repetitive motion injury (RMI), cumulative trauma disorders (CTDs), or overuse disorders.
