Ergonomic
Stories from our Medical Professionals By Janet Hoyler, BA, RDMS, RVT
As a new sonographer, it seemed like a no
brainer to adapt good working habits and understand and implement appropriate
ergonomic principles. Knowing about repetitive stress injuries, I wanted to
safeguard myself as much as possible. Unfortunately, it quickly became apparent
that there were other factors that may be completely out of the control of the
sonographer that directly relate to the ability to adhere to ergonomic
principles. We can control our equipment,
room setup, and positioning, but one thing we can't always control is our
patients!
Injury
while scanning patients
Two weeks after graduation, I was asked to
perform an ultrasound of an abdominal aorta on an emergency department patient.
When the patient arrived for their exam, it was immediately obvious that this
exam wasn't going to be an easy one. He was a man of large stature, and had a
prominent “beer belly”. Once we started the exam, he was uncomfortable. Even at
the lowest frequencies, I had to push so
hard that my arm was visibly shaking just to be able to identify the lumen
of the aorta. After a few minutes, he decided to change his positioning on the
stretcher, and this shift of his pelvis led to the probe slipping and a
hyperextension of my wrist. My wrist was sprained, and I was put on light duty
for 2 weeks.

Where
do we draw the line?
My managers wanted to know if I thought this
was a preventable injury. I could have decided to stop, and explained to the
reading physician that the exam could not be completed due to the patient's
body habitus, but instead, my determination to get the diagnostic information,
and the patient's unexpected movement set me up for injury.
Martin Altersberger, MD. Prof. Dr. Thomas
Binder

In the case of working in an emergency
environment, we do often forget how important it is to take care of yourself as
well, not only the patient. If you are exhausted after hours of scanning and
your whole body is sore, you won’t be able to keep up the good clinical work
for your patient. Often I personally feel back pain, due to the way I have to
deal with high BMI patients and the wrong rotation, I would call it, in the
case of scanning. Consider
this...
At what point do you “draw the line” and
decide that the risks associated with your efforts outweigh the diagnostic
relevance of the exam?
Bio -
Janet Hoyler has been in the field of medical
imaging for 17 years. After graduating
from the University of Delaware with a major in Psychology, a minor in
linguistics, and a concentration in cognitive science, she kicked off her
career by working as a clinical research associate specializing in medical
imaging. After several years, she
continued on her imaging career trajectory by attending Bunker Hill Community
College, and attaining an associates degree in General Sonography. She was then hired by Massachusetts General
Hospital, where she performed general sonography, cross-trained as a vascular
technologist, specialized in neurovascular and pediatric Sonography, and taught
CPR. She holds ARDMS registries in abdomen,
ob/gyn, and vascular. After 5 years at
MGH, Janet ventured into the world of point-of-care imaging, where she has
worked as a clinical application specialist, and more recently as an
educator. The department of Emergency
Medicine at Brigham and Women's Hospital employed her to train their physicians
and physician assistants, as well as medical students from Harvard. With experience in most areas of ultrasound,
including MSK, basic Echo, and more, she was then hired by 123sonography to be
the Clinical Content and Key Account Manager for North America. Additionally, she has lectured at
conferences, and been a key speaker at hands-on workshops. As well as
participating in courses at the Harvard Macy Institute, Janet will be finishing
her master's degree in healthcare education in the near future.
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