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.