Safety of Ultrasound Exposure: Knowledge, Attitudes, and Practices of Australasian Sonographers

Abstract

Introduction: While perceived as safe, diagnostic ultrasound has the potential to cause biological effects on the body tissues. The aim of this study was to evaluate knowledge, attitudes, and practices of Australasian sonographers on bioeffects and safety of ultrasound scanning. Methods: Focus groups were used to develop a questionnaire to explore knowledge, attitudes, and practices of ultrasound safety, which was then distributed to Australasian sonographers. Thematic (focus groups) and descriptive (questionnaires) analyses were undertaken. Results: A 37-item questionnaire addressed knowledge, attitudes, and practices of ultrasound safety. In 47 collected responses, sonographers demonstrated good familiarity of thermal index (TI) (79%), mechanical index (MI) (68%), and "as low as reasonably achievable" (ALARA) principle (85%). However, most sonographers could not accurately define TI (13%) and had poor knowledge of safety guidelines relating to TI (19%) and MI (14%). Over 30% were uncertain about their attitudes to ultrasound safety issues. While 52% always and 30% most of the time adhere to ALARA, 37% of sonographers reported never monitoring TI and MI. Discussion: While familiar with safety terms, knowledge of safety guidelines was lacking. Many sonographers were uncertain about their attitudes to the safety of scans, and safety practices involving monitoring for bioeffects were not a high priority.

Patient understanding of diagnostic ultrasound examinations in an Australian private radiology clinic

“…Evidence to date has not provided sufficient evidence to prove ultrasound has harmful outcomes in humans. 32 However, research on animal tissue, in particular the brain, has shown adverse bioeffects such as tissue heating and cavitation. 24 It is therefore important to limit ultrasound exposure especially in the human foetus and neonates as these are more sensitive to potentially harmful bioeffects.…”

“…24 It is therefore important to limit ultrasound exposure especially in the human foetus and neonates as these are more sensitive to potentially harmful bioeffects. [23][24][25]32 Both international and Australian guidelines advise that ultrasound imaging only be used when medically necessary and to keep scanning time to a minimum, as possible subtle and long-term effects in both foetal and adult tissue are not fully understood. 25,33 A small proportion of our participants (2.2%, 6/271) believed that ultrasound could cause cancer which may reflect participant's lack of understanding of the different imaging modalities.…”

Imaging individuals with obesity

“…• Understand personal limits around work-related musculoskeletal disorders (WRMSD) and ask the patient to move to different positions where possible rather than using awkward positions just to get the best image. • Monitor TI and mechanical index (MI) settings on the machine and be mindful of scanning times with obstetrics [74] .…”

Australian sonographers’ perceptions of patient safety in ultrasound imaging: Part 1 – identifying the main safety concerns, a qualitative study

“…6 Sonographers' perceptions of patient safety focus on bioeffects and safe operation of ultrasound equipment. 7 However, there are other patient safety risks associated Australian sonographers' perceptions of patient safety in ultrasound imaging: Part 1 -identifying the main safety concerns, a qualitative study with sonography practice. Intimate examinations such as testicular and transvaginal (TV) examinations pose physical and psychological risk to patients.…”