Unstable SCI, can they move arms in CT?

[Farid Pouralikhan]

Sorry.
Not at all.
If I understand Johan correct, the pt. is immobilized on spine board with 
stifneck...I cannot imagine more protection even for a SCI pt.. At least 
there will be mobilisation but only through "authorized personal"? 
(physiotherapist/ nurse from the SC-dept.)
IMHO this is a bit to much. I am interested in the SC-depts. advice HOW to 
move this pt. correctly and how to do a neurological examination without 
moving the pt. at all...

Just my 2cts.

Farid Pouralikhan
Surgeon
BG Trauma Centre Duisburg Buchholz
Duisburg / Germany
----- Original Message ----- 
From: "William Bromberg" <brombwi1 at memorialhealth.com>
To: <trauma-list at trauma.org>
Sent: Tuesday, September 04, 2007 5:28 PM
Subject: Re: Unstable SCI, can they move arms in CT?


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]


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