Abstract
We report a 3970 gm term infant who sustained bilateral Erb's palsies, left facial palsy, and right hemidiaphragm paralysis because of a difficult delivery. Cyanosis, tachypnea and shallow respirations persisted, requiring mechanical ventilation and oxygen supplementation. We hypothesized that placing the arms above the head would expand the chest, allow more efficient use of intercostal and accessory muscles, and improve ventilation. This was tested by measuring arterial blood gases when the arms were extended down at the sides and when the arms were up beside the head: Summary and conclusions: Ventilation is markedly improved by positioning the arms above the head. This has relevance in management of hypoventilation due to neuromuscular problems, flail chest from rib fractures, severe rickets, and chest deformities.
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