Unstable SCI, can they move arms in CT?

[William Bromberg]

I'm afraid you're being met with silence on this issue because there is no good data on arm motion affecting SCI patients. Frankly I've never considered it an issue, nor have I ever heard/read about a case of arm motion worsening SCI. The only contraindication to raising the arms above the head for CT at our institution is pain do to UE fractures.

Has anyone else ever thought that arm raising was an issue?

Bill Bromberg

>>> <johan.malmgren at vgregion.se> 09/02/07 5:16 AM >>>
Everytime we have a patient with suspected spinal cord injury there's a discussion when doing the initial trauma-CT about mobilization of the arms. To get the best possible CT pictures the CT tech wants the patient to have his/her arms above head (well, above in the direction of continuing the bed :) ), and it is up to the traumaleader's approval to arrange this. The patients are on spine board and with stiff neck collar.
 
Now, we're having a meeting in a few days about problems concerning trauma patients in the xray dept (why are they there if unstable etc etc), and it turns out that our spinal cord dept wants to send a nurse or physiotherapist on every suspected SCI-trauma to be the one giving approval for arm movement. Personally I think we're too crowded as it is. 
 
My question for the group is: Has there been any well performed studies of what actually happens with an unstable SCI when doing these manouvres? What are your local traditions with this? I would like to attend this meeting with some good science in my back pocket! :)
 
 
Johan Malmgren 
Resident, Anaesthesia, Critical Care & Traumatology
Dept of Anaesthesia and Critical Care
Sahlgrenska University Hospital
Gothenburg, Sweden
+46313428073 [Work]
+46707696961 [Mobile]