1. AbstractAbstract Eighty percent of sonographers suffer from musculoskeletal disorders. This is attributed to the combination of sustained pinching and pushing needed during some ultrasound procedures. In order to alleviate the need for the sonographer to apply a sustained force, we developed a design that can apply a force for the duration of the procedure. The design consists of an arc attached over the echocardiogram bed connected to a transducer by a arm. Movement is possible via a slider over the arc, a ball and socket joint, a hinge joint, and a rotating joint where the transducer is attached. The sonographer locks the arm in place to sustain a force and performs the detailed movements necessary.

2. Problem Statement Motivation: Sonographers apply high levels of force while performing detailed movements, increasing work-related injuries. Goal: To develop an ergonomic design to minimize the forces applied and improve the current ultrasound procedure. Motivation: Sonographers apply high levels of force while performing detailed movements, increasing work-related injuries. Goal: To develop an ergonomic design to minimize the forces applied and improve the current ultrasound procedure.

3. BackgroundBackground Relevant Ultrasound ProceduresRelevant Ultrasound Procedures –Echocardiogram Duration: 45 min.Duration: 45 min. –Biopsy Duration: 30-60 min.Duration: 30-60 min. sln.fi.edu/biosci2/monitor/images/echo.jpg

4. BackgroundBackground Musculoskeletal disorders occur in 80% of sonographersMusculoskeletal disorders occur in 80% of sonographers –Carpal Tunnel –Tendonitis –Shoulder Bursitis http://www.everybody.co.nz/gifs/carpal.jpg http://www.orthone.com/hand/shoulder.asp

5. Product Specifications The design will:The design will: –Not interfere with data collection –Reduce force applied over long periods of time –Reduce strain on joints –Allow for precise movements and adjustments –Be adaptable –Be able to maintain a stable position The design will:The design will: –Not interfere with data collection –Reduce force applied over long periods of time –Reduce strain on joints –Allow for precise movements and adjustments –Be adaptable –Be able to maintain a stable position

6. Design Options Transducer handle re-designTransducer handle re-design –Decouple the ‘push’ and ‘pinch’ Complete transducer re-designComplete transducer re-design –Force is applied using entire hand in ‘handle bar’ grip position Arc with mechanical armArc with mechanical arm Transducer handle re-designTransducer handle re-design –Decouple the ‘push’ and ‘pinch’ Complete transducer re-designComplete transducer re-design –Force is applied using entire hand in ‘handle bar’ grip position Arc with mechanical armArc with mechanical arm

7. Evaluation Grid Handle redesign Transducer redesign Mechanical arm Ability to reduce force 113 Ability to make precise movements 213 Comfort123 Feasibility312 Ease of use 322 Adaptability to different people 133 Lack of interference with procedures 322 Total1412*18* Scale:3-High2-Medium 1-Low

8. Design: Arc with Slider Arc clamps to sides of bedArc clamps to sides of bed Arc is able to rotate under the bedArc is able to rotate under the bed Slider moves along arc and locks in placeSlider moves along arc and locks in place Arm is attached to the sliderArm is attached to the slider Arc clamps to sides of bedArc clamps to sides of bed Arc is able to rotate under the bedArc is able to rotate under the bed Slider moves along arc and locks in placeSlider moves along arc and locks in place Arm is attached to the sliderArm is attached to the slider

9. Design: Arm Arm consists of two lockable jointsArm consists of two lockable joints –Ball and socket joint attached to slider attached to slider –Hinge joint attaches second portion of arm second portion of arm Transducer is attached at end of armTransducer is attached at end of arm –Has the ability to make small adjustments Arm consists of two lockable jointsArm consists of two lockable joints –Ball and socket joint attached to slider attached to slider –Hinge joint attaches second portion of arm second portion of arm Transducer is attached at end of armTransducer is attached at end of arm –Has the ability to make small adjustments www.mcmaster.com

10. Design Evaluation AdvantagesAdvantages –Manual force not needed for long durations –Allows for many positions without ‘twisting’ arm DisadvantagesDisadvantages –Not applicable to all ultrasound procedures –Does not allow for fast position adjustments –Complex to lock and maintain stability AdvantagesAdvantages –Manual force not needed for long durations –Allows for many positions without ‘twisting’ arm DisadvantagesDisadvantages –Not applicable to all ultrasound procedures –Does not allow for fast position adjustments –Complex to lock and maintain stability

11. Ethical Issues AestheticsAesthetics Testing of the sonographer/patientTesting of the sonographer/patient Safety of components for sonographer and patientSafety of components for sonographer and patient Injury during use of deviceInjury during use of device Accommodation for variability in patient size and weightAccommodation for variability in patient size and weight AestheticsAesthetics Testing of the sonographer/patientTesting of the sonographer/patient Safety of components for sonographer and patientSafety of components for sonographer and patient Injury during use of deviceInjury during use of device Accommodation for variability in patient size and weightAccommodation for variability in patient size and weight

12. Future Work: Arc Attachment to bedAttachment to bed Design clamp to fit bed and arcDesign clamp to fit bed and arc Determine best place of attachmentDetermine best place of attachment Rotating arc under bedRotating arc under bed Find a ball and socket joint for arcFind a ball and socket joint for arc Eliminate problem of bed handle preventing rotationEliminate problem of bed handle preventing rotation Attachment to bedAttachment to bed Design clamp to fit bed and arcDesign clamp to fit bed and arc Determine best place of attachmentDetermine best place of attachment Rotating arc under bedRotating arc under bed Find a ball and socket joint for arcFind a ball and socket joint for arc Eliminate problem of bed handle preventing rotationEliminate problem of bed handle preventing rotation

13. Future Work: Arc Allow height adjustments at ends of arcAllow height adjustments at ends of arc Motion of sliderMotion of slider Lock slider in placeLock slider in place Reduce frictionReduce friction Current ideas:Current ideas: Rollers on the inside of the sliderRollers on the inside of the slider Teflon coatingTeflon coating Material: Stainless steelMaterial: Stainless steel

14. Future Work: Arm  Determine best materials  Lock joints  Devise an easier method to adjust the second arm length  Lock adjustable arm  Determine method of attachment of transducer

15. Future Work: Transducer  Phalange  improve comfort for sonographer  Soft springs  allow for natural movements of patients  Detachable transducer  facilitate cleaning, different transducers  Mechanism to allow sonographer to make small adjustments  Surround transducer handle with ball bearings

16. Future Work: Construction Determine correct dimensions of all componentsDetermine correct dimensions of all components Depends on location and method of clamping arcDepends on location and method of clamping arc Find appropriate bending machine for arcFind appropriate bending machine for arc Determine best method to construct sliderDetermine best method to construct slider

17. AcknowledgementsAcknowledgements Chris Arnold - MachiningChris Arnold - Machining Nicola Ferrier, PhD – RoboticsNicola Ferrier, PhD – Robotics Dr. Frank Fronczak – Materials, Joints, MachiningDr. Frank Fronczak – Materials, Joints, Machining Timothy Hall, PhD – Mock TransducersTimothy Hall, PhD – Mock Transducers John Ma – Rapid Prototyping and SolidWorksJohn Ma – Rapid Prototyping and SolidWorks Robert Radwin, PhD – ErgonomicsRobert Radwin, PhD – Ergonomics Tim Walker – SonographerTim Walker – Sonographer Chris Arnold - MachiningChris Arnold - Machining Nicola Ferrier, PhD – RoboticsNicola Ferrier, PhD – Robotics Dr. Frank Fronczak – Materials, Joints, MachiningDr. Frank Fronczak – Materials, Joints, Machining Timothy Hall, PhD – Mock TransducersTimothy Hall, PhD – Mock Transducers John Ma – Rapid Prototyping and SolidWorksJohn Ma – Rapid Prototyping and SolidWorks Robert Radwin, PhD – ErgonomicsRobert Radwin, PhD – Ergonomics Tim Walker – SonographerTim Walker – Sonographer

18. ReferencesReferences Kliewer, Mark. UW Hospital. Radiology Dept. Personal Interview. January 2004.Kliewer, Mark. UW Hospital. Radiology Dept. Personal Interview. January 2004. The Franklin Institute Online. sln.fi.edu/biosci2/monitor/images/echo.jpg. Last accessed 4/29/04.The Franklin Institute Online. sln.fi.edu/biosci2/monitor/images/echo.jpg. Last accessed 4/29/04. Orthopaedics Northeast Website. www.orthone.com/hand/shoulder.asp. Last accessed 4/29/04.Orthopaedics Northeast Website. www.orthone.com/hand/shoulder.asp. Last accessed 4/29/04. Everybody Health website. New Zealand. www.everybody.co.nz/gifs/carpal.jpg. Last accessed 4/29/04.Everybody Health website. New Zealand. www.everybody.co.nz/gifs/carpal.jpg. Last accessed 4/29/04. McMaster Carr website. www.mcmaster.com. Last accessed 4/29/04.McMaster Carr website. www.mcmaster.com. Last accessed 4/29/04. Kliewer, Mark. UW Hospital. Radiology Dept. Personal Interview. January 2004.Kliewer, Mark. UW Hospital. Radiology Dept. Personal Interview. January 2004. The Franklin Institute Online. sln.fi.edu/biosci2/monitor/images/echo.jpg. Last accessed 4/29/04.The Franklin Institute Online. sln.fi.edu/biosci2/monitor/images/echo.jpg. Last accessed 4/29/04. Orthopaedics Northeast Website. www.orthone.com/hand/shoulder.asp. Last accessed 4/29/04.Orthopaedics Northeast Website. www.orthone.com/hand/shoulder.asp. Last accessed 4/29/04. Everybody Health website. New Zealand. www.everybody.co.nz/gifs/carpal.jpg. Last accessed 4/29/04.Everybody Health website. New Zealand. www.everybody.co.nz/gifs/carpal.jpg. Last accessed 4/29/04. McMaster Carr website. www.mcmaster.com. Last accessed 4/29/04.McMaster Carr website. www.mcmaster.com. Last accessed 4/29/04.