Suspension Trauma: What To Do When You Are Left Hanging?

What is Suspension Trauma?

Suspension Trauma, also known as ‘orthostatic intolerance’, ‘harness-induced pathology’,or the term I prefer, ‘suspension intolerance’ is a reasonably unknown hazard to many safety officers; or employees working in an environment that puts them at risk of experiencing suspension trauma.

Before I go further, please note that the information that follows is my opinion; based on various factors of competency, as defined in the Construction Regulations.

Those people who are responsible for generating or following through on rescue plans or similar facets of working at height; should attend recognized courses and keep themselves up to date with the current, best practices in treating someone who may be experiencing suspension trauma.

In a nut-shell, someone who is hanging in their harness can experience certain symptoms (some of which may include nausea, light-headedness, tingling or numbness, visual impairments, dizziness, unconsciousness and if left untreated for long enough, death).

This is where the term I referred to earlier comes from (suspension intolerance), meaning the unfortunate person who is hanging in their harness, may have blood ‘pooling’ in their leg-veins & will become intolerant of the effects.

Without clean, oxygenated blood flowing as it should, the blood that is trapped (often by harness straps) becomes ‘dirty’, in that the casualties’ muscles have used the oxygen & nutrients.

Now comes the tricky part, and again; there are a few different views on treatment.

I’m not going to give you the answers because I’m not a doctor or subject matter expert – but consider these questions:
– What would happen if you allowed that ‘dirty’ blood to rush back into the casualties system?
– Would lying the casualty in the recovery position directly after rescue; allow blood to run quickly or slowly back into the persons’ system?
– Would it perhaps be more beneficial to slowly lie the casualty down, bit by bit, slowly allowing the trapped blood to run free; by loosening his/her harness?
– Do your harnesses allow for effective treatment, based on your answers to the above?

At SRM we recommend:

• Ensure your first aiders know what to do in the event of a fall,
• Ensure the paramedics know what Suspension Trauma is, and how to deal with it (research the effects of administering Oxygen),
• Take a good look at your PPE systems, and whether the harnesses allow for the person to be rescued and treated in the best manner (basically you’re looking at the difference between dorsal or sternum attachments, and dealing with a casualty who is hanging with their face OR back towards the ground).
• Take both conscious & unconscious casualty rescue’s into account (one can ‘treat’ & rescue themselves, the other can’t).
• ALL falls that involve an energy absorber that has been deployed, must go to the hospital for a checkup and X-rays (internal injuries from the shock-load experienced during an incident of this nature).
• Considering whether you are ready to deal with the related injuries that often occur alongside suspension trauma…neck and back injuries, lacerations, broken bones etc.

It is your responsibility to ensure this hazard (or risk, depending on how you look at it) is effectively mitigated.

Courses that cover First aid levels 1, 2 and 3 do not include how to treat suspension trauma, or the specific methods to mitigate further injury.

You will have to do work at height related courses, and balance the feedback from the facilitators with your company’s Occupational Medical or Health Practitioner.

Rather pay your dues upfront, than deal with an incident of this nature that could have been avoided or mitigated.

Stay safe.

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