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To Stand or Not to Stand...
Author(s): Janet Hoyler, BA, RDMS, RVT
ArticleOther contents by this Author

To Stand or Not to Stand...

by Janet Hoyler, BA, RDMS, RVT

As we learn to scan, some feel more comfortable sitting, while others prefer to stand.  Which is the better choice? The answer is not a straightforward one, as the preference is highly subjective, and includes factors that may not be immediately evident to the sonographer. Let me illustrate why in the following—

It was an exciting day—new exam tables showed up for our department and were those things fancy!  They had both a remote and foot switch to control the height and angle of the bed, sections that would drop away to get closer to the patient, and even arm attachments for those difficult upper extremity vascular studies. I was truly thrilled—that is, until I had to perform a transvaginal pelvic exam.  

Sure, the bed had stirrups, and its foot dropped as needed, but at full height, the bed didn't even reach my waist!  As a taller sonographer, at 5'10" (178 cm), I found myself at a very significant awkward lean, trying to find something to support my arm.  After a day working in the outpatient clinic doing one pelvic exam after another, my excitement for the new tables had turned into disgust. My back and neck were throbbing, not to mention my arm!  

My only option was to get used to scanning these exams while sitting. In my mind, when I think of sitting while performing an ultrasound exam, I picture someone sitting as they would in a regular chair with their knees at an approximately 90° bend.  Thank goodness, this doesn't have to be the case. Since I preferred to scan standing, I used an ergonomic chair at full height, which allowed me to mimic a standing position, at a lower level. Once I got used to scanning in this ‘assisted standing’ position, it slowly became my default for most exam types.  

Did you know that most ultrasound machines, at full height, are too short for sonographers that are taller than 5'8" (173 cm)? If you are a tall sonographer and have noticed back or neck pain after a day of exams using portable machines, this may be the reason why. These portable exams are ergonomically problematic for a number of reasons, including the following:

  • - We have no control over the other machinery present in the patient's room.
  • - There may or may not be an appropriate chair available for use in the room.
  • - Patient beds are significantly larger than stretchers and exam tables, naturally positioning our bodies and machines farther away from the patient.  

There is often no solution for these issues, and we as sonographers sometimes need to think creatively to safeguard ourselves from injury. Here are some tips to consider:

- Placing clean towels on the side of the patient bed may give you a place to lean or sit.  
- Rolling towels to use as arm supports can be an arm and shoulder-saver.  
- Learning to scan ambidextrously or upside down may allow you to position yourself around equipment instead of fighting with its location.
- Working with a partner may allow for one to scan and the other to run the machine and is a great learning experience for student sonographers!  

The SDMS has reported that repetitive stress injuries will impact 90% of sonographers during the length of their scanning career.  With this staggering statistic in mind, we as sonographers need to look out for our well-being. I will often share this statistic with other healthcare professionals who may initially believe that my request to reposition things in the patient’s room is exaggerated or excessive. The general impression of our profession is that we passively rub gel and a wand over the skin and see babies, yet the majority of people, including fellow healthcare professionals, do not realize how physically challenging our profession can be.  

Sonography is a passion.  Safeguard yourself, and politely educate others as to why we do what we do.

Please find comprehensive ergonomic information and statistics from the SDMS at the following website: