Positioning, steep tredelenburg and shoulder braces

[cwharper]

Well, I've been out of school for two years now and one of the things I remember most about positioning and that they seemed to drill in our heads was never to use shoulder braces to hold the patient on the table during tredelenburg because they were shown to cause brachial plexus injury. Now at our facility it seems that the surgeons are starting to want to use them again and get really upset when I tell them I won't put them on. So far the only surgeries they want to use them on is Laparascopic Total Hysterectomy with or without BSO and Laparascopic pelvic surgery where the surgeon wants the patient in the steepest tredelenburg possible. One surgeon seemed to have a study (haven't seen it yet) that said there were more incidences of femoral nerve injury from the stirrups without using the braces than there were brachial plexus injuries while using them.

I brought this to the attention of chief after one day I refused to do a case where they wanted to use them and on a least two other incidences I wouldn't relieve the CRNA because they were using them.

Well, the Chief CRNA and at least two other CRNA's fully agreed with me about the dangers of shoulder braces and said I was perfectly within my right to refuse to do the case.

I need to know if shoulder braces are now becoming common practice because right now I don't feel like I would have very much of a defense in court if I used them, had an injury, and then several expert witnesses testified they were banned at their facilities.

[YakimaDes]

BUMP!

I am in process of educating our staff regarding the dangers of shoulder braces in steep t-berg. Such are dangerous and have been shown to cause brachial plexus injuries. I am writing here to find the write-up that I believe was in the ASPF newsletter a few years prior...can anyone here offer assistance?

cheers!