Clinical safety

CHAPTER 1


Clinical safety




Key terms


acoustic exposure 


amount of acoustic energy the patient receives.


ALARA principle 


as low as reasonably achievable; used to reduce biological effects in humans and the fetus.


biological effect 


effect of ultrasound waves on living organisms, including their composition, function, growth, origin, development, and distribution.


cavitation 


interaction of the sound wave with microscopic gas bubbles found in tissues.


epidemiology 


studies of various factors determining the frequency and distribution of diseases in the human community.


ergonomic 


study of the human body at work.


ex vivo 


refers to experimentation done in or on living tissue in an artificial environment outside the organism.


in vitro 


refers to the technique of performing a given experiment in a test tube or, generally, in a controlled environment outside a living organism.


in vivo 


refers to experimentation done in or on the living tissue of a whole, living organism as opposed to a partial or dead one. Animal testing and clinical trials are forms of in vivo research.


mechanical index (MI) 


describes the likelihood of cavitation occurring.


Occupational Safety and Health Act (OSHA) 


an act passed by Congress to assure safe and healthful working conditions.


pulse average (PA) 


average intensity throughout the pulse duration.


radiation force 


force exerted by the sound beam on an absorber or reflector.


spatial average (SA) 


average intensity across the entire sound beam.


spatial peak (SP) 


peak intensity found across the sound beam.


temporal average (TA) 


average intensity during the pulse repetition period.


temporal peak (TP) 


greatest intensity during the pulse.


thermal index (TI) 


relates to the heating of tissue.


thermal index for bone (TIB) 


relates to the heating of bone.


thermal index for cranium (TIC) 


relates to the heating of the cranium.


thermal index for soft tissue (TIS) 


relates to the heating in soft tissue.


Work-Related Musculoskeletal Disorders (WRMSD) 


injuries that are caused or aggravated by workplace activities including injuries of the muscles, tendons, and joints.





Work-related musculoskeletal disorders (WRMSD)






Types of injuries





Prevention of injury




• Position examination table at a proper height with the patient close enough to avoid bending and reaching.


• Place monitor directly in front of operator, positioning the monitor height so eyes are even with the top of the monitor.


• Ergonomic chair positioned for proper back alignment and foot support to avoid twisting and reaching.


• Keep elbow close to body with shoulder abduction at an angle ≤30 degrees.


• Maintain neutral hand position.


• Avoid resting wrist on the keyboard.


• Wear properly fitting glove to maintain a loose grip on the transducer (avoid pinch grip).


• Never place transducer cord around the neck.


• Neutral position of neck to avoid bending or twisting.


• Avoid static work posture; alternate between standing and sitting positions.


• Use of ergonomic support cushions.


• Position ultrasound system close to body.


• Regular stretching and strengthening exercises.


• Proper nutrition and sleep.



Bioeffects and ALARA principle


Safety





ALARA principle




• As Low As Reasonably Achievable (ALARA).


• Achieve information with the least amount of energy exposure to the patient.


• Use of high receiver gain and low output power.


• Power should be decreased in obstetric and pediatric examinations.


• Exposure time should be kept to a minimum.


• Benefit must outweigh risks.




Intensity of ultrasound







Jun 15, 2016 | Posted by in GYNECOLOGY | Comments Off on Clinical safety

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