Do you know the importance of having a rescue plan in place? Harness suspension trauma can be life threatening when a worker sustains a fall. Educating workers and having a rescue plan in place can prevent this from happening and save lives. Here are some terms you need to know that related to suspension trauma:
- Fall Arrest System: A series of equipment components designed to stop the fall of individuals working at heights should they fall.
- Orthostatic Hypotension: In suspension trauma, this refers to the pooling of blood in the leg veins of a worker that occurs when individuals fall in harnesses, are suspended in confined spaces, etc. and are forced to hang vertically with their legs relaxed (immobilized).
- Reflow Syndrome: The return of pooled, hypoxic blood and its metabolic byproducts from the extremities to the heart (more about this later).
- Rescue Death: When related to suspension trauma, this type of death occurs in patients who appear physiologically stable during the rescue and extrication but suddenly die after being freed.
- Suspension Trauma: Injuries Sustained from being immobilized in a vertical position when the legs are relaxed and immoble. Injuries include hypoxia (insufficient oxygen reaching the tissues); syncope (loss of muscle strength and/or fainting); hypoxemia (abnormally low levels of oxygen in the blood causing shortness of breath); acidosis (excessive acid in the body fluids or tissues, build up to CO2); ventricular fibrillation (irregular contractions of the heart where the chambers quiver uselessly instead of pumping blood, generally followed by sudden cardiac arrest); myocardial infarction (heart attack or literally “death of heart muscle”); damage to the liver, kidneys and brain; and possibly death.
- Suspension Syndrome: The condition in which a suspended person becomes unconscious due to orthostasis (upright hanging position) without traumatic injury.
Being Immobilized in a Harness
When a worker experiences a fall and becomes immobile in a safety harness in as little as three minutes they will first feel dizzy, sweaty and signs of shock including increased pulse and breathing. Then there will be a sudden drop in pulse and blood pressure which can cause an instant loss of consciousness (typically 5-30 minutes after a fall). If this happens, the brain has no oxygen supply and their airway is at risk which can lead to death.
After a fallen worker has been rescued, it is important to follow these steps to prevent the pooled blood from rushing back into their heart and brain all at once:
- Whatever plan you have written, it is vital that the lowering system can be controlled to prevent the worker’s body from being laid flat as it reaches the ground.
- Anyone released from immobile suspension should be kept in a sitting position for at least 30 minutes
- Keep the harness on and do not release the leg straps
- Try to get the person to sit in the ‘W’ position (legs pulled towards chest) if possible