Proper ergonomic practices throughout your ultrasound career is so incredibly important that it can’t be overstated. The reason why having proper ergonomics is so important is because “per a recent study”, 90% of sonographers are scanning in pain. How can that be?!
We have to put our bodies in strange positions, apply more pressure than maybe necessary, and scan in pain for long periods of time.
The more stress we put on our bodies, the faster our bodies will break down. The next thing you know, you are going through physical therapy, pain management, and MSK surgeries. Let’s try to avoid this outcome at all costs.
So, how to reduce injury?
Stand Rather Than Sit
Scanning while standing gives you the ability to move around with your patient. Sitting in a chair obviously forces you into a more fixed position.
Allow your body to move around, lean against the bed, move cranially or caudally based on what part of the patient you are imaging.
This idea may not be everyone’s cup of tea, but when scanning TV exams, stand in between the patient’s legs (if you have a OB/GYN bed where it has stirrups). Reason being, is this is the best placement for you shoulder to NOT be in pain. Reason being, you don’t have to abduct your arm at an awkward angle and rely all on all the strength coming from the shoulder. Give it a try and see what you think.
Don't Hold All The Weight Of The Transducer + Cord
This can destroy your shoulder fast if you are holding onto the entirety of the weight from both the transducer and cord. How do we fix this?
- Hang the cord onto the plastic “hangers” under the keyboard
- Loop the cord around the notches in the transducer holders adjacent to the keyboard
- Utilize an arm band that latches the cord in place and takes the strain away from your shoulder
Some people wrap the cord around their neck, however I would refrain from doing this because
- Cord could be dirty…
- Applies unecessary weight to your neck… We don’t need to create a neck problem…
Fix Patient Position
I used to be terrible at telling patients how I want them to lay on the stretcher. But after scanning in pain for so long, it’s time to take the extra time and master patient position to help me scan.
For some reason patients like to lay on the opposite side of the stretcher (or as far away from us as humanly possible). Tell them to scoot closer to you so you refrain from stretching your arm to far. Ouch shoulder pain.
When you LLD the patient, have them scoot their body backwards towards you. They always tend to roll so far away from us. Again we want to refrain from stretching our arm too far away from us.
Another thing to think about is to move the stretcher around as well! Don’t be scared to move it.
Utilize The Machine
Our machines are built to help us practice good ergonomics. So why not utilize that?
- Adjust the screen so you don’t strain your neck.
- Raise or lower the keyboard as well as moving it back and forth or side to side. This really helps if we do have to stretch across the patient. HOWEVER, really try to avoid stretching across the patient at all times.
- Move the machine around. It has wheels.
Avoid Stretching Across The Patient
I understand that we image patients who are on the larger side, or if in ICU, they are surrounded by medical equipment especially if they are intubated or on dialysis. This can be challenging and maybe force us to reach across because we need to grab an image of the left kidney.
How do we fix this so we don’t reach across the patient?
- Bring a co-worker with you. You scan on the opposite side of the bed and your coworker manages the machine.
- Have a floor nurse hit the freeze and print buttons for you if a co-worker is not an option.
- If working independently (which I have done this many many times with a great success rate), image the left kidney on the opposite side of the bed, then place the transducer down, walk back to the machince and hit freeze. Scroll back and find your image. Hit print. This does take quite a bit more time but this beats having an MSK injury and being in pain. Also utilize the CINE option so you do less walking back and forth.
Stretch
I stretch at least 2 times a day now after having my MSK injury. Unfortunately it took me getting this injury to realize the importance of warming up your muscles and joints and staying warm.
I stretch in the morning for about 10-15 minutes, and do the same again on my lunch break. If I can I go for a walk on my lunch break as well. Staying active and healthy is so important in our line of work. I know we take care of other people, but don’t forget about the most important person — you.
That's A Wrap!
Implement these tactics into your scanning routine and take care of yourself. You shouldn’t have to scan in pain, so don’t!
