Figure 1. Sonographer performing scan.
Sonographers may be required to move patients or sonography equipment to various areas of the health care facility. This may
require forceful pushing or pulling of imaging equipment, patient
transport equipment (e.g., gurney, wheelchair, etc.) over differing floor
materials and transitions for a significant distance. In
addition, sonographers may be required to assist patients onto and off
the exam table when they arrive on any of a variety of transport
devices (e.g., gurney, wheelchair, etc.). This may require heavy lifting in an awkward
Patients and Equipment
Some sonography tasks increase the amount of push or pull force that sonographers must exert
when moving patients or equipment from one area to another. An increase
in force exertion may increase the risk of injury to the back, legs and shoulders.
- Exerting force in awkward postures, such as bending or reaching, due
to handles or push points that are too high or too low.
- Any unexpected, abrupt stoppage or deceleration when moving equipment
resulting in the use of excessive force and awkward body postures.
- Wheels that are the wrong size for the transitions between flooring
types or rooms.
- Wheels that are too small to easily pass over gaps between elevator
and main floor.
- Obstructions placed in line of travel.
- Damaged floor.
- Debris that is left on floor increasing the amount of force exerted,
often in awkward postures.
- Moving equipment with wheels (casters) that are poorly maintained or
are inappropriate for the flooring surface. This results in the use of
excessive force and awkward body postures.
Figure 1. A powered assist device can assist with
movement of heavy equipment.
Figure 2. Wheels on ultrasound equipment
Gurney with appropriate mechanisms for control and braking.
|Figure 4. Larger
wheels require less force during transport and when moving over
||Figure 5. Brakes and
swivels on back wheels provide stability and maneuverability.
Figure 6. Sonographer using proper body mechanics to move ultrasound
- Use smaller handheld equipment to perform bedside studies, whenever
it is available and appropriate.
- Use mechanical powered assist devices whenever large or heavy
patients or equipment must be moved for longer distances. (Figure 1)
- Ensure that equipment has the appropriate wheels (casters) to
facilitate safe transport over all flooring and room conditions. (Figure
2 and 3)
- Generally, wheels that have a larger diameter, a narrower width
and are made of a harder material will traverse gaps and changes in
flooring more easily, reducing the necessary push force. (Figure 4)
- Swivel casters should be used when maneuvering in tight locations.
Note: At least one set of casters should be lockable to provide
improved inline steering. (Figure 5)
- Ensure that all equipment is maintained according to established
schedules and that all employees understand the procedure for reporting
- Controls for equipment should be easily accessible without bending
or reaching. These may include controls that allow selection between
two-wheel, four-wheel and braked positions. Central locking is
- Handles should be placed on the swivel caster end of equipment to
ensure that sonographers push or pull from this end.
- Ensure that a sufficient number of employees are available to move
large or heavy patients and equipment. An individual employee should not need to exert
a force of more than about 50
pounds at any point during the transport.
- Floors should be clean and free of debris which may cause the wheels
to get stuck while in motion.
- Aisles should be kept open and free of extraneous items such as
gurneys, wheelchairs or other carts.
- Ensure that employees are aware of the procedures to report damage
to flooring and walkways.
- Sonographers should be trained to use correct body mechanics when moving patients, wheelchairs, beds,
stretchers and ultrasound equipment. Correct body mechanics suggestions may
include: (Figure 6)
- Push instead of pull. Lean slightly into the load to let your body
weight assist with force exertion.
- Push at about chest height.
- Push smoothly and slowly to start.
- Do not bend or twist while exerting force.
- Keep wrists straight.
- Keep elbows close to the body.
The layout of the examination room may have an impact on the sonographer
making equipment hard to maneuver and position.
- Doorways that are too narrow may require frequent turning
and repositioning to get patients and equipment into the exam room. More
force is required when starting, stopping or turning during transport
- Inappropriate flooring material (e.g., thick carpet) or elevated or
pronounced transitions between rooms and halls make movement of patients
and equipment more difficult and may require the use of excessive force.
- Examination rooms that are too small make it difficult to properly
arrange the patient and equipment for a variety of procedures.
- Examination rooms that are arranged for only one configuration
force sonographers to repeatedly use the same body posture or motions
for prolonged periods of time. This increases the risk of injury to the shoulder, elbow,
wrist and hand.
- Lighting that does not include dimmer switches or controls, makes
monitors difficult to read. This may lead to eye strain and back and
neck discomfort as sonographers lean forward to detect items on the screen.
- Repeated or prolonged use of extended or elevated reaches to access
used for procedures can stress the
shoulder and back.
Examination rooms should:
- Provide adequate space for maneuvering and orienting people and equipment
around the exam table, allowing access from all sides.
- Have doorways that allow easy access for wheelchairs, beds and
ultrasound equipment, minimizing the amount of turning and repositioning.
- Have hard surface flooring which allows easy movement of equipment.
Anti-fatigue mats or pads can be placed around the exam area if
sonographers must stand for
- Provide easy access to imaging supplies such as having supplies available in a number of locations.
- Have equipment such as thermal printers or recording devices in an
area that reduces reach but allows the equipment to be accessed. Placing
equipment or supplies on carts or stands may increase mobility and
- Have controllable environmental conditions, especially light levels.
Switches, curtain or blind mechanisms should be placed in convenient
- Provide adequate ventilation and temperature controls to ensure the
comfort of the sonographer and patient while allowing the equipment to
Transferring Patients to and from the Exam Table
Sonographers may need considerable support and assistance to move patients onto
or from examination
- Pushing or pulling to position beds, gurneys and wheelchairs prior
to transferring patients can require exertion of significant force,
especially when dealing with bariatric (obese) patients, carpeted floors or poorly maintained
wheels and casters.
- Assuming awkward postures such as bending, twisting or reaching when
moving patients from wheelchairs, beds or gurneys to the exam table.
Awkward postures, especially when combined with the exertion of force,
increases the risk of injury to the back, shoulders, and lower and upper extremities.
- Using significant force when lifting bariatric patients from
wheelchairs, beds or gurneys, increases the risk of injury to the back and
- Use mechanical powered transfer devices such as lifts or hoists to move
patients, especially bariatric or non-ambulatory, from wheelchairs,
beds, or gurneys.
- When appropriate, use multi-use devices such as chairs that can open up
into beds. These allow
patients to move from a sitting position to a prone position, without
- Additional employees should assist in moving and transferring equipment or patients
- A mechanical powered device is not available.
- Awkward postures must be used.
- Push force exceeds about 50 pounds.
- The amount of weight that the sonographer must support is in excess of 40-50