Always raise the arm which is closest to the x-ray tube, this reduces thyroid dose and acts as a filter 'hardening' the beam BEFORE entering the patient. Therefore any photons which pass the patients midline are photons you want to reach the cassette/image plate.The only thing that raising the arm closest to the image plate will do is degrade or reduce useful information reaching the plate.
Modern practice is that any patient presenting with significant C.spine trauma should proceed to CT following a single cross table lateral view, and in some cases even this is not done. If the patient is intubated an AP and Peg views are ruled out and even if C7/T1 is demonstrated most physicians would still ask for CT.
Low kV high(er) mAs technique is also essential in the production of good images. Radiographers who use kVs of above 85 have forgotten how the image production process and human anatomy work.

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