Ergonomic positioning is important in any medical procedure, but can be particularly challenging with ultrasound-guided injections given that the practitioner is balancing multiple implements and will also need to direct assistance in their roles. Ergonomic positioning is important to avoid practitioner injury, optimize patient comfort, and obtain the best possible procedure outcome. Positioning may vary between practitioners and patients. In order to avoid practitioner injury, the practitioner should get close enough to the patient that it is not necessary to lean forward or to the side during the procedure, adjust the height of the bed, be sure that there is easy access to the transducer without straining the wrist, elbow, shoulder, or spine, and it is also important to ensure that the ultrasound display is in view. At our institution, we use a neoprene suspension device to assist with positioning of the patient. The suspension device can be easily manufactured by following the instructions provided in this video. You will need to gather the following materials to make the suspension device, hammer, scissors, two inch wide neoprene, Velcro with adhesive backing, a revolving leather hole punch, and two metal rivets. Using two inch wide neoprene, cut a piece 22 and a half inches in length. Using two inch wide Velcro with adhesive backing, cut a piece one inch in length. Fold the end without Velcro over one and a half inches. Cut a quarter of an inch slit over the center of the fold. You now have a 1-1⁄2 inch opening at one end. Fold the end with Velcro over 2-1⁄2 inches. Cut a 1-1⁄2 inch slit over the center of the fold. On the Velcro end of the suspension device, make two holes with a leather hole punch over the Velcro for the metal rivets. The rivets are used to secure the Velcro to the suspension device. The holes are made approximately 3 fourths of an inch from each side of the neoprene. The metal rivets are inserted into the pre-made holes. Using a hammer, the rivets are secured in place. The end of the suspension device without Velcro is inserted into the 1-inch opening at the Velcro side of the strap. The strap is tightened around the wrist, allowing the Velcro end to secure to the neoprene. The other end of the strap is attached to an IV pole with locking wheels. This allows the practitioner to ergonomically position the upper limb during the botulinum toxin injection. www.ottobock.com

ultrasound-guided injections

ergonomic positioning

practitioner safety

patient comfort

neoprene suspension device