Fig. 23.1
Strategic placement of buttons on the gantry (Source: BreastCheck, Ireland)
Easy Height Adjustment of Equipment
Only a light touch should be required to depress buttons and reaching the buttons should be almost effortless. Buttons are replicated both on the tube head and side of the breast platform, so radiographers can use the set of controls that are easiest to access from their position, or alternate between controls to help reduce repetitive movements and the risk of repetitive strain.
The NHSBSP guidelines indicate that it is good practice to offer a choice in how to manipulate the system, and ergonomic development will help vary routine and reduce repetitive strain injuries [3, 4] (Fig. 23.2).
Fig. 23.2
Ease of reaching equipment buttons on tube head (Source: BreastCheck, Ireland)
Motorised Compression
Smooth breast compression technology is achieved by the use of a foot switch, which allows radiographers to use their hands for positioning the breast. A number of features that may help to reduce injury include:
(a)
Some units do not require mammographers to make physical changes to the compression paddle between small and large women, thereby reducing the risk of strain.
(b)
Where it is not necessary to shift the compression paddle for each oblique view of the smaller breast, demands on the hands and wrists are minimised.
(c)
Where hand-controlled compression knobs for fine-tuning the level of compression are avoided, the need for repeated twisting of the wrist is reduced.
(d)
Use of a high-edge paddle pushes the contra-lateral breast back, and supports it away from the field of view. This means that the mammographer does not need to ask (or assist) the client to do this during the oblique projections, thereby reducing the risk of injury.
Acquisition Workstation
Musculo-skeletal injury can be associated with repetitive keyboard use and this can be reduced by limiting the number of steps requiring the use of a mouse or keypad through the mammography process, or by employing touchscreen technology.
Room Design
Careful design of the mammography room can also help to reduce musculo- strains and improve workflow. The working triangle should be as small as possible whilst including considerate choice of equipment. The design of the reporting room should also be considered as many radiographers are now involved in image interpretation as well as mammography. The same principles will apply to radiographers involved in extended roles, such as ultrasound.
Positioning Considerations
1.
Adopt good communication skills with the client as this will enable her to move independently rather than being moved.
2.
Rather than using the thumb and forefinger to support the whole breast, use the whole hand, or as much of the hand as possible to position the breast (Fig. 23.3).
