Occupational safety instructions for an ultrasound diagnostic doctor in the antenatal clinic department. Instructions for preparing for an ultrasound examination. Preparation for an ultrasound of the abdominal cavity. Instructions for using ultrasound machines.
In order to diagnose or clarify the diagnosis, an ultrasound examination of the internal organs is performed. Its quality depends not only on the qualifications of the doctor, but also on the device itself. Let's consider the advantages of ultrasound devices, their types, how much an ultrasound machine costs and an overview of well-known device manufacturers.
It is known that ultrasound was first discovered by an Italian scientist more than two centuries ago. Now ultrasound is used in all areas of medicine, regardless of the patient’s age. This is a minimally invasive, harmless and painless method that helps to examine the structure, position and structural features of internal organs.
Ultrasound examination is used in almost all areas of medicine. But all devices, depending on the nuances of the study, can be divided into three groups: for gynecology and obstetrics, for studying the cardiovascular system, and universal devices.
The most common are multifunctional ultrasound machines, which have maximum performance and can examine any organ.
Characteristics of devices for ultrasound:
- design - it can be portable, portable or stationary;
- image reproduction - standard (2D mode, M mode and Doppler), advanced options (color Doppler, B-Flow, advanced stress echo studies, tissue harmonics, Easy 3D);
- screen diagonal - a portable ultrasound machine has a small screen (similar to a laptop), stationary monitors are more massive, which are easier to work with;
- sensors - 2-3 sensors are suitable for all studies, but for highly specialized examinations up to 6 pieces may be needed;
- scanning depth - depends on the area of study (kidneys are examined at a depth of up to 36 cm, the heart - up to 24 cm, in gynecology and obstetrics - up to 15 cm);
- weight - depends on the type of device and its dimensions.
Types of devices for ultrasound examination
An ultrasound machine, the price of which depends on its design and capabilities, is selected by a clinic or medical center depending on the area of use.
All devices for ultrasound examination can be divided into four groups:
- Simple ultrasound scanners.
These are most often portable devices with 16 reception and transmission channels. The image is reproduced in black and white.
- Middle class devices.
They have 32 reception and transmission channels.
- High-end devices.
They have 64 reception and transmission channels and a built-in color Doppler.
- High class ultrasound.
New generation devices that are equipped with color systems and platforms.
Advantages of ultrasound machines
Using ultrasound machines, you can not only conduct research, but also perform a number of manipulations. For example, biopsy, puncture or drainage.
Advantages of modern ultrasound scanners:
- Visualization of internal organs at a high level - modes can be selected.
- Compactness of the devices.
- Ease of use (this depends on how much the ultrasound machine costs);
- Additional options.
- You can connect different types of sensors.
- Autonomy of work.
Review of ultrasound device manufacturers
Leaders in the ultrasound equipment market, regardless of the classification and type of device, are considered to be such global brands as General Electric, Toshiba, Philips, Siemens, Hitachi Aloka. Their products are distinguished by high quality, ease of use and a long warranty period with service.
Most often, these companies are chosen by multidisciplinary medical institutions. Manufacturers from the USA, Europe (France, Denmark, Italy), Canada, Japan, Korea, India and Israel have also proven themselves well. Chinese devices are chosen less often, but recently they are not inferior in quality to European or American devices.
The price of an ultrasound machine depends not only on the manufacturer, but also on the number of functions it contains and where the components were manufactured. Often parts for the device are not produced in the brand’s home country, which affects its quality and reduces the cost of production significantly.
Criterias of choice
In order to choose a device and get acquainted with how much an ultrasound machine costs, it is worth determining many nuances. First of all, decide on the tasks that the device will perform and how high quality they should be.
What to look for when choosing an ultrasound examination device:
- device class - from a simple device to a high-quality device;
- scope of application - can be a universal or narrow-profile device;
- type - stationary or portable (depending on where and how it will be used);
- number and type of sensors;
- scanning and image reproduction (color or black and white).
Regardless of the device chosen, it requires special care. After each patient, the sensors are cleaned and disinfected. It is also worth periodically carrying out maintenance after a certain period of operation and correcting errors in the work in a timely manner. The accuracy of the study depends on these activities.
Review of devices for ultrasound examination
To decide on the choice of device, you should carefully study its characteristics and capabilities. Ambulance teams often use portable devices, while medical institutions prefer stationary devices that have more functionality.
Review of ultrasound machines from well-known manufacturers:
- General Electric Voluson E8 (3.4 million rubles).
This is a stationary device that has a good price-quality ratio. It is distinguished by volumetric visualization due to the introduction of new technologies, as well as ease of use.
- Toshiba Aplio 300 (about 2 million rubles).
This is a universal stationary scanner that is compact (does not take up much space in the room), low price and high quality of work. It is equipped with a tissue Doppler and automatic adjustment of image parameters, which makes the diagnostician’s work much easier.
- Toshiba Aplio 400 (1.7 million rubles).
Compared to the previous model, the functionality of the device has been slightly changed. It features high performance, a 19-inch monitor and a different number of sensors that can be connected to the device thanks to 4 active connectors.
- Siemens Acuson S2000 (1.3 million rubles).
Stationary system for diagnostics in various fields of medicine. It features detailed research, as well as volumetric visualization in 3D and 4D formats.
- Toshiba Aplio MX (4.1 million rubles).
A universal device that is often used to conduct research on seriously ill patients. It is convenient, compact, portable and has a wide arsenal of functionality.
- General Electric LOGIQ E (1.1 million rubles).
This is a portable ultrasound scanner that is small in size and has high performance. They can conduct complex studies regardless of the patient’s location. It looks like a small laptop, so it is often used by mobile teams to provide emergency assistance.
- Philips ClearVue 350 (RUB 1.3 million).
This is a mobile device. The device itself is on a trolley, so it can be used not only in one office. It is distinguished by its mobility, ease of use and good image quality.
Features of a portable ultrasound machine
The portable scanner is convenient for diagnosing the condition of patients on the go. It is successfully used in various fields of medicine and veterinary medicine. Just a few years ago they were inferior in quality to stationary installations; now they are produced of high quality and have quite a wide range of functionality.
Externally, the device resembles a laptop and weighs up to 8 kg. They can be easily transported, various modes and several ports for connecting different sensors are already built in. Leading manufacturers of portable devices include companies such as Mindray and AcuVista (China), Honda and Toshiba VIAMO (Japan), GE Logiq and Sonosite (USA), Siemens (Germany) and Philips (Netherlands).
How much does a portable ultrasound machine cost? Its price varies from 5 to 40 thousand dollars (328,000 - 2.6 million rubles).
Which ultrasound machine is better?
It is impossible to say for sure which device is better: portable, mobile on a trolley or stationary. Hospitals and medical centers use versatile and multifunctional devices. In intensive care conditions, it is easier to use mobile devices on a trolley, and for emergency services - portable scanners. An ultrasound machine is selected depending on the specifics of the provision of services.
Ultrasound machine: how much it costs, review, characteristics. Portable ultrasound machine - tips and recommendations about health on the site
In order to carry out a diagnosis or clarify the diagnosis, it is carried out. Its quality depends not only on the qualifications of the doctor, but also on the device itself. Let's consider the advantages of ultrasonic devices, their types, how much they cost, and an overview of well-known device manufacturers.
It is known that ultrasound was first discovered by an Italian scientist more than two centuries ago. Now ultrasound is used in all areas of medicine, regardless of the patient’s age. This is a minimally invasive, harmless and painless method that helps to examine the structure, position and structural features of internal organs.
Scope of application and characteristics of ultrasound machines
Ultrasound examination is used in almost all areas of medicine. But all devices, depending on the nuances of the study, can be divided into three groups: for gynecology and obstetrics, for studying the cardiovascular system, and universal devices.
The most common are multifunctional ultrasound machines, which have maximum performance and can examine any organ.
Characteristics of devices for ultrasound:
- design - it can be portable, portable or stationary;
- image reproduction - standard (2D mode, M mode and Doppler), advanced options (color Doppler, B-Flow, advanced stress echo studies, tissue harmonics, Easy 3D);
- screen diagonal - a portable ultrasound machine has a small screen (similar to a laptop), stationary monitors are more massive, which are easier to work with;
- sensors - 2-3 sensors are suitable for all studies, but for highly specialized examinations up to 6 pieces may be needed;
- scanning depth - depends on the area of study (kidneys are examined at a depth of up to 36 cm, the heart - up to 24 cm, in gynecology and obstetrics - up to 15 cm);
- weight - depends on the type of device and its dimensions.
Types of devices for ultrasound examination
An ultrasound machine, the price of which depends on its design and capabilities, is selected by a clinic or medical center depending on the area of use.
All devices for ultrasound examination can be divided into four groups:
- Simple ultrasound scanners.
These are most often portable devices with 16 reception and transmission channels. The image is reproduced in black and white.
- Middle class devices.
They have 32 reception and transmission channels.
- High-end devices.
They have 64 reception and transmission channels and a built-in color Doppler.
- High class ultrasound.
New generation devices that are equipped with color systems and platforms.
Advantages of ultrasound machines
Using ultrasound machines, you can not only conduct research, but also perform a number of manipulations. For example, biopsy, puncture or drainage.
Advantages of modern ultrasound scanners:
- Visualization of internal organs at a high level - modes can be selected.
- Compactness of the devices.
- Ease of use (this depends on how much the ultrasound machine costs);
- Additional options.
- You can connect different types of sensors.
- Autonomy of work.
Review of ultrasound device manufacturers
Leaders in the ultrasound equipment market, regardless of the classification and type of device, are considered to be such global brands as General Electric, Toshiba, Philips, Siemens, Hitachi Aloka. Their products are distinguished by high quality, ease of use and a long warranty period with service.
Most often, these companies are chosen by multidisciplinary medical institutions. Manufacturers from the USA, Europe (France, Denmark, Italy), Canada, Japan, Korea, India and Israel have also proven themselves well. Chinese devices are chosen less often, but recently they are not inferior in quality to European or American devices.
The price of an ultrasound machine depends not only on the manufacturer, but also on the number of functions it contains and where the components were manufactured. Often parts for the device are not produced in the brand’s home country, which affects its quality and reduces the cost of production significantly.
Criterias of choice
In order to choose a device and get acquainted with how much an ultrasound machine costs, it is worth determining many nuances. First of all, decide on the tasks that the device will perform and how high quality they should be.
What to look for when choosing an ultrasound examination device:
- device class - from a simple device to a high-quality device;
- scope of application - can be a universal or narrow-profile device;
- type - stationary or portable (depending on where and how it will be used);
- number and type of sensors;
- scanning and image reproduction (color or black and white).
Regardless of the device chosen, it requires special care. After each patient, the sensors are cleaned and disinfected. It is also worth periodically carrying out maintenance after a certain period of operation and correcting errors in the work in a timely manner. The accuracy of the study depends on these activities.
Review of devices for ultrasound examination
To decide on the choice of device, you should carefully study its characteristics and capabilities. Ambulance teams often use portable devices, while medical institutions prefer stationary devices that have more functionality.
Review of ultrasound machines from well-known manufacturers:
- General Electric Voluson E8 (3.4 million rubles).
This is a stationary device that has a good price-quality ratio. It is distinguished by volumetric visualization due to the introduction of new technologies, as well as ease of use.
- Toshiba Aplio 300 (about 2 million rubles).
This is a universal stationary scanner that is compact (does not take up much space in the room), low price and high quality of work. It is equipped with a tissue Doppler and automatic adjustment of image parameters, which makes the diagnostician’s work much easier.
- Toshiba Aplio 400 (1.7 million rubles).
Compared to the previous model, the functionality of the device has been slightly changed. It features high performance, a 19-inch monitor and a different number of sensors that can be connected to the device thanks to 4 active connectors.
- Siemens Acuson S2000 (1.3 million rubles).
Stationary system for diagnostics in various fields of medicine. It features detailed research, as well as volumetric visualization in 3D and 4D formats.
- Toshiba Aplio MX (4.1 million rubles).
A universal device that is often used to conduct research on seriously ill patients. It is convenient, compact, portable and has a wide arsenal of functionality.
- General Electric LOGIQ E (1.1 million rubles).
This is a portable ultrasound scanner that is small in size and has high performance. They can conduct complex studies regardless of the patient’s location. It looks like a small laptop, so it is often used by mobile teams to provide emergency assistance.
- Philips ClearVue 350 (RUB 1.3 million).
This is a mobile device. The device itself is on a trolley, so it can be used not only in one office. It is distinguished by its mobility, ease of use and good image quality.
Features of a portable ultrasound machine
The portable scanner is convenient for diagnosing the condition of patients on the go. It is successfully used in various fields of medicine and veterinary medicine. Just a few years ago they were inferior in quality to stationary installations; now they are produced of high quality and have quite a wide range of functionality.
Externally, the device resembles a laptop and weighs up to 8 kg. They can be easily transported, various modes and several ports for connecting different sensors are already built in. Leading manufacturers of portable devices include companies such as Mindray and AcuVista (China), Honda and Toshiba VIAMO (Japan), GE Logiq and Sonosite (USA), Siemens (Germany) and Philips (Netherlands).
How much does a portable ultrasound machine cost? Its price varies from 5 to 40 thousand dollars (328,000 - 2.6 million rubles).
Which ultrasound machine is better?
It is impossible to say for sure which device is better: portable, mobile on a trolley or stationary. Hospitals and medical centers use versatile and multifunctional devices. In intensive care conditions, it is easier to use mobile devices on a trolley, and for emergency services - portable scanners. An ultrasound machine is selected depending on the specifics of the provision of services.
Instructions for preparing for an ultrasound examinationPreparing for an abdominal ultrasound
The main obstacle to performing an abdominal ultrasound is the presence of air. Therefore, the main task of preparing for an ultrasound examination is to remove all excess air from the intestines.
2 days before the study, foods that cause gas formation should be excluded from the menu: raw fruits and vegetables, brown bread, milk, sparkling water, marinades and home-canned food, high-calorie confectionery - pastries, cakes.
If the study is planned in the morning, then it is necessary to exclude breakfast (do not eat or drink)
If the study is scheduled after 13.00, a light breakfast is allowed 6 hours before the study, excluding the above products.
Preparation for abdominal ultrasound of the pelvic organs:
For a high-quality transabdominal examination of the pelvic organs, it is necessary to fill the bladder. Against the background of a full bladder, it is possible to clearly see the internal genital organs. In this case, you need to drink 300-500 ml of water in 30-45 minutes. before the study.
Ultrasound to determine the sex of the child is performed at 15-16 weeks
Preparation for transvaginal ultrasound of the pelvic organs:
Transvaginal ultrasound is performed on an empty bladder
R 2.2.4/2.2.9.2266-07
2.2.4. PHYSICAL FACTORS OF THE WORKING ENVIRONMENT
2.2.9. HEALTH STATE OF WORKERS
DUE TO THE STATE OF THE WORKING ENVIRONMENT
Hygienic requirements for working conditions of medical workers,
performing ultrasound examinations
Management
APPROVED by the Head of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare, Chief State Sanitary Doctor of the Russian Federation G.G. Onishchenko August 10, 2007.
1. Scope and general provisions
1. Scope and general provisions
1.1. This manual is intended for specialists from bodies and organizations of Rospotrebnadzor, Roszdravnadzor, RAMS, organizations that develop, produce and operate medical ultrasound diagnostic equipment.
1.2. The manual contains hygienic requirements for medical ultrasound diagnostic equipment, the offices and workplace of an ultrasound doctor, the organization and conduct of ultrasound diagnostic studies, organizational and therapeutic and preventive measures for the improvement of the health of ultrasound doctors.
1.3. These hygienic requirements apply throughout the Russian Federation and are aimed at preventing the adverse effects of a complex of harmful factors in the working environment and the labor process when working on the health of ultrasound doctors with medical ultrasound diagnostic equipment.
1.4. The development, production and operation of medical ultrasound diagnostic equipment must be carried out in accordance with the requirements of sanitary legislation - SanPiN 2.2.4/2.1.8.582-96, SP 2.2.2.1327-03 and other documents.
1.5. The employer must ensure the safe and efficient operation of medical ultrasound diagnostic equipment in accordance with the requirements of applicable labor and health laws, user manuals and these requirements.
1.6. Monitoring of compliance with these requirements is carried out by Rospotrebnadzor authorities in accordance with SP 1.1.1058-01 and other documents of the current sanitary legislation.
1.7. With the entry into force of this manual, “Hygienic recommendations for optimizing and improving the working conditions of health workers engaged in ultrasound diagnostics” R N 3992-85 become invalid.
2. Basic terms and definitions
Contact ultrasound- ultrasound transmitted by contact when hands or other parts of the human body come into contact with an ultrasound source through liquid and solid media.
Maximum permissible level (MAL) of ultrasound- a level that, during daily (except for weekends) work, but not more than 40 hours a week, throughout the entire working experience, should not cause diseases or deviations in the state of health, detected by modern research methods during work or in the long term of life of the present and subsequent generations. Compliance with ultrasound guidelines does not exclude health problems in hypersensitive people.
Medical diagnostic ultrasound equipment (or system)- a combination of a control unit (remote control) for an ultrasonic device, a monitor and sensors that make up a comprehensive diagnostic system.
Sensor- a component of ultrasonic diagnostic equipment, including an ultrasonic transducer with built-in elements, which is a source of contact ultrasound that affects the patient and the doctor’s hands.
Rated frequency- ultrasonic frequency at which the ultrasonic sensor operates, indicated by the developer or manufacturer in the accompanying documentation.
Supporting documentation- description, instruction manual, passport and technical conditions supplied by the manufacturer to medical ultrasound diagnostic equipment, containing its technical characteristics, safety requirements for operation, etc.
3. Requirements for medical ultrasound diagnostic equipment
3.1. Medical ultrasound diagnostic equipment must comply with these requirements and must have a formalized sanitary and epidemiological certificate.
3.2. The levels of contact ultrasound affecting the hands of medical personnel should not exceed the maximum permissible level established in SanPiN 2.2.4/2.1.8.582-96 for the operating frequency range (1.0-31.5 MHz) of ultrasonic diagnostic equipment - no more than 110 dB or 0.1 W/cm.
3.3. Associated factors of the working environment that arise during the operation of medical ultrasound diagnostic equipment (noise, electromagnetic fields, visual and neuro-emotional stress, forced working posture, etc.) must comply with the requirements of the current sanitary legislation.
3.4. The temperature of the side surfaces of sensors intended for contact with the hands of medical personnel should not exceed 40°C.
3.5. Acceptable visual parameters of information display devices for medical ultrasonic diagnostic equipment (video display terminals - hereinafter - VDTs, monitors, screens, etc.) are presented in Section 5 of these requirements.
3.6. Concentrations of harmful substances released into indoor air when performing scans using medical ultrasound diagnostic equipment should not exceed the maximum permissible concentrations (MPC) established for atmospheric air.
3.7. The aeroionic composition of indoor air must comply with the requirements of current sanitary standards.
3.8. The exposure dose rate of soft X-ray radiation at any point at a distance of 0.05 m from the screen and housing of the VDT of medical ultrasonic diagnostic equipment (on a cathode ray tube) at any position of the control devices should not exceed 1 μSv/h (100 μR/h).
3.9. The design of medical ultrasound diagnostic equipment should include painting the body in calm, soft colors with diffuse light scattering. The case, keyboard and other equipment components must have a matte surface with a reflection coefficient of 0.4-0.6.
3.10. The design of the VDT of medical ultrasound diagnostic equipment must provide for brightness and contrast control.
3.11. Documentation for the design, manufacture and operation of medical ultrasonic diagnostic equipment must comply with SanPiN 2.2.4/2.1.8.582-96 and these requirements.
3.12. Ultrasonic diagnostic equipment must have accompanying documentation containing information about acoustic parameters - the acoustic output of all sensors: the nominal frequency and output power of ultrasound, the area of the working surface of the sensor.
4. Requirements for ultrasound diagnostic rooms
4.1. The set of premises intended for equipping ultrasound diagnostic rooms must comply with SanPiN 2.1.3.1375-03 and must include the following premises:
- for carrying out diagnostic studies at a rate of at least 14 m2 with a recommended area of at least 20 m2 per installation, provided that each ultrasound diagnostic installation must be located in a separate room;
- for undressing and dressing a patient with an area of at least 7 m2, adjacent to the room for diagnostic studies;
- for waiting for an appointment at the rate of 1.2 m per patient, but not less than 10 m.
4.2. It is prohibited to place ultrasound diagnostic rooms in basements, semi-basements and basements.
4.3. The room for ultrasound diagnostics must have:
- natural and artificial lighting;
- sink with cold and hot water supply;
- general supply and exhaust ventilation system with an air exchange rate of 1:3. Installation of air conditioners is recommended.
4.4. In rooms for diagnostic studies, it is recommended to maintain the following microclimate parameters: air temperature 22-24°C, relative humidity - 40-60%, air speed - no higher than 0.15 m/s.
4.5. The walls in the ultrasound diagnostic room should be painted in light colors. Wall cladding with ceramic tiles is prohibited.
4.6. Noise levels at the workplaces of medical personnel servicing ultrasound diagnostic units should not exceed 50 dBA.
4.7. In order to reduce noise in ultrasound diagnostic rooms, it is recommended to line the ceilings and walls with sound-absorbing materials.
4.9. The couch (with adjustable height) should be installed in the center of the room or at some distance from the walls to facilitate access to the patient from any side.
4.10. Diagnostic equipment should be installed in such a way that it is possible to easily carry out studies in various planes.
4.11. The height of the couch for patients should be selected such that the ultrasound physician conducting the diagnostic examination creates conditions that meet the requirements of the “SSBT. Workplace when performing work while sitting. General ergonomic requirements.”
4.12. Electrical devices that may cause interference with the operation of ultrasound equipment should not be placed in the ultrasound diagnostic room.
5. Requirements for the workplace of an ultrasound diagnostic doctor
5.1. The ultrasound doctor's workplace must comply with the requirements of SanPiN 2.2.2/2.4.1340-03.
5.2. The ultrasound doctor's workplace should be placed in such a way that the VDT of the medical equipment is oriented with its side facing the light opening, and natural light falls predominantly from the left.
5.3. Artificial lighting in the rooms of ultrasound diagnostic rooms should be provided by a system of general uniform lighting.
5.4. Lighting should not create glare on the surface of the screen. The illumination of the screen surface should not be more than 300 lux.
5.5. Direct glare from light sources should be limited, and the brightness of luminous surfaces (windows, lamps, etc.) in the field of view should be no more than 200 cd/m.
5.6. Reflected glare on work surfaces (screen, keyboard, etc.) should be limited due to the correct choice of types of lamps and the location of workplaces in relation to sources of natural and artificial lighting, while the brightness of glare on the monitor screen, VDT of medical diagnostic equipment should not exceed 40 cd/m and the ceiling brightness should not exceed 200 cd/m.
5.7. The glare index for sources of general artificial lighting in ultrasound diagnostic rooms should be no more than 20.
5.8. The brightness of public luminaires in the area of radiation angles from 50 to 90° with the vertical in the longitudinal and transverse planes should be no more than 200 cd/m, the protective angle of the luminaires should be at least 40°.
5.9. The uneven distribution of brightness in the field of view of the ultrasound physician should be limited, and the brightness ratio between working surfaces should not exceed 3:1-5:1, and between working surfaces and the surfaces of walls and equipment - 10:1.
5.10. As light sources for artificial lighting, predominantly LB-type fluorescent lamps and compact fluorescent lamps should be used.
5.11. To illuminate ultrasound rooms with medical ultrasound diagnostic equipment, lamps with mirror parabolic grilles, equipped with electronic ballasts, should be used. It is allowed to use multi-lamp luminaires with electromagnetic ballasts (ECGs), consisting of an equal number of leading and lagging branches.
The use of luminaires without diffusers and shielding grilles is not permitted.
In the absence of luminaires with electronic ballasts, lamps of multi-lamp luminaires or nearby general lighting luminaires should be switched on to different phases of a three-phase network.
5.12. The safety factor (Kz) for general lighting lighting installations should be taken equal to 1.4.
5.13. The ripple factor should not exceed 5%.
5.14. When ensuring standardized illumination values in ultrasound rooms, glass window frames and lamps should be cleaned at least twice a year and burnt-out lamps should be replaced in a timely manner.
5.15. The maximum permissible values of visual parameters of the VDT of medical ultrasound diagnostic equipment, monitored at the workplaces of ultrasound doctors, are presented in the table.
Visual parameters of VDT of medical ultrasound diagnostic equipment, controlled at the workplaces of ultrasound doctors
|
Name of parameters |
Valid values |
|
White field brightness [email protected] If the payment procedure on the payment system website has not been completed, monetary An error has occurred Payment was not completed due to a technical error, funds from your account |
Chapter 1. General requirements for labor protection
1. Individuals who have appropriate medical education and training in their specialty, have theoretical knowledge and professional skills in accordance with the requirements of current regulatory legal acts, and have no contraindications to work in this specialty are allowed to independently work on diagnostic ultrasound machines (hereinafter referred to as ultrasound machines). for health reasons, having undergone preliminary (upon entry to work) and periodic (during work) medical examinations in accordance with the established procedure.
2. Women during pregnancy and breastfeeding should not be involved in work in the area of constant and alternating magnetic fields, electromagnetic radiation, ultrasound and electrostatic fields.
Books on certification of workplaces for working conditions in, "Bamboo" (Ukraine)
3. When working on devices, workers must be trained in safe methods and techniques for performing work, given introductory instructions on labor protection and instruction on labor protection in the workplace, undergo an on-the-job internship and test their knowledge of labor protection.
Repeated training on labor protection must be carried out at least once every six months.
When working with electrical medical devices, the employee must have 1 electrical safety group.
4. Medical devices must comply with the requirements of TNLA and documents of manufacturing organizations.
5. All medical electrical devices must:
have a technical passport;
be equipped with grounding;
be in good condition.
6. Employees are obliged to:
observe the work and rest regime established by law, the internal labor regulations of the organization, labor discipline, comply with labor protection requirements, personal hygiene rules;
comply with fire safety requirements, know the procedure for action in case of fire, be able to use primary fire extinguishing agents;
Smoking only in designated smoking areas;
know first aid techniques in case of accidents;
report malfunctions of ultrasound machines and other comments on working with medical equipment, instruments and instruments to the head of the office or persons performing maintenance of the equipment;
comply with labor protection requirements, as well as rules of behavior on the territory of the institution, in production, auxiliary and household premises;
maintain order in your workplace;
undergo medical examinations, training (training), retraining, advanced training and testing of knowledge on labor protection issues in accordance with the procedure established by law;
perform your official duties carefully;
use equipment and tools strictly in accordance with the manufacturers' instructions;
correctly use personal and collective protective equipment in accordance with the conditions and nature of the work performed.
7. When performing work with devices, medical workers may be exposed to the following dangerous and harmful production factors:
biological factor in patient care;
contact and air ultrasound;
electromagnetic radiation of the radio frequency range;
electric and magnetic fields;
increased voltage in an electrical circuit, the closure of which can occur through the human body;
electrostatic fields, non-ionizing radiation;
optical radiation in the infrared and ultraviolet range;
aeroion composition of air;
responsibility for the functional quality of the final result;
responsibility for the safety of others.
8. To ensure optimal microclimate parameters, regular ventilation and daily wet cleaning of the premises are carried out during the working day. Periodically, at least once a month, general cleaning should be carried out with washing of walls, floors, doors, window sills, and the inside of windows.
9. When working in ultrasound rooms with installed medical equipment, workers must be provided with access to primary fire extinguishing equipment and first aid kits. The employee must know the list of medications included in the first aid kit, know its location, and be able to use fire extinguishing equipment.
10. Connection of medical devices to the electrical network is carried out only using a three-pole plug with a neutral wire. The three-pole plug of the power cable must be connected to an appropriate outlet with reliable grounding. Do not use an adapter or a two-pole socket to connect to the network.
11. When operating the devices, use only the supplied network cables and connect them only to grounded outlets.
12. The devices must be placed in a place protected from light and heating devices, with constant air temperature and humidity, working ventilation, away from dust, chemicals, and sources of water ingress.
13. When working with devices, taking into account the dangerous and harmful production factors affecting them, medical personnel must be provided with personal protective equipment (hereinafter referred to as PPE), in accordance with the Standard Industry Standards for the free issuance of personal protective equipment, approved by the Resolution of the Ministry of Labor and Social Protection from 09/01/2008 for No. 129.
|
Name |
|
|
When employed as an ultrasound diagnostic doctor: |
|
|
Mi knitted gloves - until worn out |
|
|
Medical mask - until worn out |
|
|
When working as a nurse: |
|
|
Medical gloves BM - until worn out |
|
|
Medical mask (respirator) – until worn out |
|
|
When working in a clinic, additionally: |
|
|
Mi leather shoes – 24 months. or Mi leather slippers – 12 months. |
14. When performing work on ultrasound machines, the employee must work only in special medical clothing, strictly observe the rules of personal hygiene, after performing each type of work and after visiting each patient, wash his hands with warm water and soap, and thoroughly dry the skin of his hands after washing with a dry individual towel. Do not allow medicinal allergens (antibiotics, novocaine, polymers, etc.) to come into contact with exposed skin surfaces. Do not use flammable substances or other liquids for hand washing.
15. Installation, connection of peripheral devices, testing of ultrasound systems System safety compliance and maintenance must be performed by trained technical personnel.
16. Ultrasound room equipment should provide for the complete exclusion of the possibility of contact of service personnel and patients with open live parts when performing work on them.
17. It is prohibited to use chemical containers for drinking water and eat food in undesignated places.
18. It is not allowed to perform work while in a state of alcoholic, narcotic or toxic intoxication, as well as drinking alcoholic beverages, using narcotic, toxic and psychotropic substances during working hours and at the place of work.
19. A medical worker is obliged to perform work stipulated by the employment contract, provide assistance and cooperate with the employer in ensuring healthy and safe working conditions, immediately notify his immediate supervisor or other official about the malfunction of equipment, tools, devices, protective equipment, about the deterioration of his health.
20. If deficiencies in operation and equipment malfunctions are identified during work, employees must notify the office manager about this.
21. Employees who do not comply with the requirements of these instructions will be held accountable in accordance with the law.
Chapter 2. Labor protection requirements before starting work
22. Check the serviceability of personal protective equipment necessary to perform the work, put on special medical clothing, special shoes and other personal protective equipment.
23. Before starting to work with ultrasound machines, the employee must:
ventilate the work area;
check the stability of the equipment position on the work table, correctly and rationally place tools and materials, remove foreign objects;
check for visible damage to equipment, fixtures and tools, their serviceability and completeness;
serviceability and integrity of power and connecting cables, detachable and plug connections, protective grounding;
check the operation of ventilation systems, fencing and safety devices, automatic control and alarm devices;
check the condition of the furniture. The doctor's work chair must be adjustable in height and have the required angle of inclination of the back of the chair. The doctor’s workplace should be located no closer than 20 cm from sockets and electrical wiring hidden in the walls that power electrical devices.
24. Adjust the lighting in the workplace, make sure there is sufficient lighting, and if necessary, turn on local lighting.
25. Carry out work in strict sequence according to the operating instructions for the ultrasonic device. Do not turn on the devices with wet hands.
26. Only service personnel are allowed to enter the office while ultrasound machines are operating.
27. The worker must reset the controls at the beginning of each examination. Ultrasound machines should only be used if available reasonable medical indications.
28. When working with ultrasound machines, it is necessary to use a sensor that provides resolution and sufficient depth of focus.
detection of device malfunctions;
presence of damaged cables or wires, connectors, plug connections;
absence or malfunction of the protective grounding of the equipment.
30. Detected violations of labor safety requirements must be eliminated on their own, and if it is impossible to do this, employees are required to report them to the head of the office. It is prohibited to independently eliminate malfunctions of ultrasound devices associated with their repair and adjustment; repair of devices must be carried out in specialized organizations or by specialists of the organization.
Chapter 3. Labor protection requirements during work
31. Those working on ultrasonic ultrasound machines are prohibited from:
leave the workplace and leave patients unattended;
touch any live parts of the equipment, remove protective panels and casings;
use wires with damaged insulation;
allow unauthorized persons into the workplace.
32. When working with ultrasound machines, it is necessary to use equipment, tools and devices in strict accordance with the operating requirements set out in the passports of these devices and operating instructions.
33. When working with ultrasound machines, workers are prohibited from:
work on faulty devices, with faulty devices, alarms, insulation, carry out any manipulations inside the devices;
contact of the doctor’s hands with the scanning surface of the working sensor;
contact of lubricant with the doctor’s hands;
work on ultrasound machines without personal protective equipment (cotton gloves);
work with the ventilation, water supply, and sewage systems turned off;
use devices with open protective equipment (covers, casings);
subject ultrasound devices and sensors to sudden mechanical impacts, exert increased mechanical stress on handles and other controls;
Do not place containers with liquids on the panels of the devices, do not allow moisture to get inside the devices.
34. All procedures for servicing ultrasound devices should be carried out with the devices disconnected from the electrical network. Routine cleaning of sensors should be carried out between procedures in strict compliance with the operating instructions. Do not use aerosols to clean the keyboard, monitor, external surfaces, and slide controls.
35. When performing work on ultrasound machines, it is necessary to use methods that allow research to be carried out in a short time. In this case, it is necessary to reduce the exposure time regardless of the value of the acoustic index.
36. The temperature of the side surfaces of sensors intended for contact with the body of patients or workers should not exceed 40 degrees C.
37. It is not allowed to squeeze the sensor by force while the ultrasound machine is operating. Scanning the hand must be performed with the joints in an optimal position and in a balanced position.
38. A worker using ultrasound machines must use breaks in work sufficient to restore normal function of muscles and ligaments.
39. It is not allowed to carry out wet cleaning in the room when the ultrasound machine is turned on.
40. It is prohibited to store and use drugs without labels, in damaged packaging, with expired expiration dates, and to taste and smell the drugs used.
41. It is prohibited to eat in the workplace, as well as to store food products and household clothing.
42. If malfunctions occur in the operation of ultrasound devices, a dangerous or emergency situation, stop work, turn off the devices in use and notify the head of the office.
Chapter 4. Labor protection requirements after finishing work
43. Upon completion of work, a person working on ultrasound machines must:
disconnect electrical devices from the network via the power cable and switch them to the operating instructions requirements mode;
remove tools, equipment and materials to their storage areas;
tidy up the workplace.
44. Remove and store sanitary and hygiene products and personal protective equipment;
discard disposable protective equipment;
turn off lighting and ventilation;
inform the head of the office about the shortcomings identified during the operation of the devices and other factors affecting labor safety;
wash your hands with warm water and soap.
Chapter 5. Labor protection requirements in emergency situations
45. A worker using medical ultrasonic ultrasound machines must stop performing work and turn off the power to the devices:
upon detection of broken power wires, grounding faults and other damage to devices;
in case of short circuit of electrical equipment and its fire;
in the event of a fire or accident.
46. In the event of a fire in electrical wiring, equipment, or similar incidents, turn off the power supply and take measures to extinguish the fire using available fire extinguishing agents using carbon dioxide or powder fire extinguishers.
The use of foam fire extinguishers and water to extinguish live electrical equipment is not permissible.
47. Turn off the supply and exhaust ventilation, immediately report the fire to the head of the office and the fire department, indicating the exact location of its occurrence, notify others and, if necessary, remove people from the danger zone.
48. In the event of malfunctions in the ventilation, water supply, or sewerage systems that impede the performance of technological operations, stop work and report this to the head of the office.
49. In case of an accident at work, you must:
quickly take measures to prevent the impact of traumatic factors on the victim, provide first aid to the victim, and call emergency medical services to the scene of the incident;
report the incident to the head of the office or the responsible (official) person, ensure the safety of the situation before the start of the investigation, if this does not pose a danger to the life and health of people.