By Carolyn T. Coffin, MPH, RDMS, RVT, RDCS
The answer is “yes.” Historically, strain and fatigue caused by the use of hand tools have been identified by a number of investigators. In the 17th century, Bernardo Ramazzini, the founder of occupational medicine, noted that scribes writing with quill pens were experiencing fatigue of the hand and wrist, which resulted from strain on the muscles and tendons. Over time, this strain led to decreased gripping strength of the hand. Other investigators have described “writer’s cramp” and “occupational neurosis” among various professions where hand tools were used extensively.1 Hand tools contribute to a large percentage of musculoskeletal disorders2, including those reported among sonography professionals.
Musculoskeletal disorders are the major cause of workplace injury in all professions and have a significant economic impact on industries. 3 Work-related musculoskeletal disorders (WRMSD) account for 56% of work-related illnesses reported to OSHA. The risk for these injuries depends on the duration of a worker’s exposure to a workplace hazard, the frequency of the exposure to that hazard, and the intensity of the exposure. Just as writing for long periods of time with a pen can cause “writer’s cramp” of the hand and fingers, long durations of holding an ultrasound transducer during a patient exam can cause fatigue of the scanning hand and fingers. When this is compounded by multiple exams performed by a sonographer during the workday, the risk for injury increases further.
The time needed for the acquisition of diagnostic-quality images varies from exam to exam and between sonographers. More experienced sonographers will require less time for an exam than those new to the profession. However, there are some factors that increase scanning time for all sonographers. These factors are exam protocols, the patient’s body habitus and medical condition, and the quality of the transducer.
The factors related to the patient are not within the control of the sonographer, but the other factors are. Exam protocols should be reviewed by the department on a regular basis to ensure that outdated and/or unnecessary images do not continue to be part of the required components. Transducers should always be maintained and repaired by an ISO 13485:2016 certified transducer repair facility with a solid track record of high-quality products and repair services. Sonographers do not always recognize when a transducer is substandard or has a broken component. As a result, they struggle through exams trying to overcome poor quality images, adding extra time holding the transducer during each exam. Once a faulty transducer is identified, the repair should be performed by a facility that uses original equipment manufacturers’ (OEMs)parts and not “counterfeit” parts. Non-OEM parts may not result in the image quality that the sonographers expect. Repair work utilizing non-OEM parts may seem less expensive up front but can ultimately result in added costs as those parts may not have the same life span of the OEM parts, thus requiring more frequent repairs. Additionally, the risk of a work-related injury increases, due in part to an increase in transducer time as the sonographers struggle to acquire a diagnostic quality image. Loss of productivity by an experienced employee who becomes injured, and medical costs for treatment of a work-related injury and Worker’s Compensation costs, have now made the cost of transducer repairs using non-OEM far more expensive than if those parts were repaired with OEM parts.
To ensure that image quality and patient care are optimal, and that your department is efficient and the risk for occupational injury is reduced, you should always research the repair facility servicing your transducers to know that you are receiving your transducer back in the best condition possible, worthy of what you are paying for.
- WRMSD In Sonographers, Grahame Brown, BMUS Bulletin, Aug. 2003, Vol 11, No. 3
- Design, selection & use of hand tools to alleviate trauma of the upper extremities: Part II- The scientific basis (knowledge base) for the guide. Anil Mital & Asa Kilbom, International Journal of Industrial Ergonomics, 10 (1992) 7-21
- Pike I, Russo A, Berkowitz J, Baker J, Lessoway V; The Prevalence of Musculoskeletal Disorders Among Diagnostic Medical Sonographers; JDMS; 13(5); Sept.-Oct. 1997: 219-27.