Unstable SCI, can they move arms in CT?

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never thought about it either

cant think about a reason not to


sal


-----Original Message-----
From: William Bromberg <brombwi1 at memorialhealth.com>
To: trauma-list at trauma.org
Sent: Tue, 4 Sep 2007 11:28 am
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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