Occupational Health and Safety - Suspension Trauma
Updated: Jun 29, 2022
Stopping a fall is merely the first step in avoiding damage or death. Even if the arrest does not result in harm, a fallen worker who is not rescued in time might die from suspension stress (orthostatic shock). Too often, a worker is rescued by a personal fall arrest system (PFAS), only to die from suspension stress while waiting for rescue.
Many safety managers, superintendents, and foremen believe that limiting the total PFAS arresting force to 1,800 pounds and preventing impact injury during a fall is enough.
Unfortunately, post-fall suspension stress and the time required for rescue are often overlooked in fall prevention efforts.
Suspension Trauma may create a life-threatening issue for a fallen worker awaiting rescue if not managed appropriately. As a result, a fall prevention strategy should always contain a rescue plan.
What Is Suspension Trauma?
Suspension trauma happens when a fallen worker's legs are hanging from a harness. While the arteries in the legs' fronts keep pumping blood, the harness straps act as tourniquets on the veins in the legs' backs, preventing used (deoxygenated) blood from returning to the heart. If circulation is severely hindered, the heart rate will drop abruptly, decreasing oxygen to the brain.
Suspension trauma must be addressed as an emergency even under perfect conditions with a rescue plan in place. It has the potential to prove lethal in as little as 10 minutes. Suspension trauma often results in mortality within 15 to 40 minutes.
Immediate Steps to Reduce the Risk of Suspension Trauma
Standing is the greatest approach to decreasing the onset of suspension stress. When a worker rises, the leg muscles must contract, putting pressure on the veins. This pressure, together with a system of one-way valves inside the veins, helps blood return to the heart and prevents blood pooling in the legs. A fallen worker might stand in one of many ways:
Suspension trauma relief straps: If a worker falls, trauma relief straps may be used to create a loop that the worker walks into and pushes against to rise up. Relief straps are often sold in two bags, one for each side of a harness.
Onsite work equipment: The onsite rescue crew may be able to provide a ladder, an aerial lift, or other equipment for the hanging worker to stand on.
Structural member: The onsite rescue crew may be able to bring the hung worker to a structural member, a lower level, or the ground.
Planning and Preparation
Everyone who works at a height must get comprehensive fall protection training. Rescue of PFAS and first aid/CPR training should be offered.
Each job site necessitates a distinct rescue approach. The supervisor should assign roles such as who calls 911 and who conducts the rescue. The supervisor should arrange ahead of time how the work equipment at the site will be used.
Employers should also provide specialized equipment for onsite assisted rescue by qualified employees, such as:
● Suspension trauma release straps, self-rescue devices, and/or technical rescue equipment.
● Pulley systems, brake-tube systems, winch systems, controlled descent devices, rope ladders, and other devices are all possible.
Whether or whether the hanging worker has lost consciousness, the rescue squad must proceed with caution. The heart's inability to withstand the suddenly increased flow of carbon dioxide-saturated blood from the legs causes post-rescue mortality. Do not place a rescued worker, aware or not, in a horizontal posture.
If the rescued worker does not have any apparent injuries from the fall, the worker should be placed in a sitting position with knees close to the chest. The position is often called a ‘W’ position. The fall victim should remain in the ‘W’ position for at least 30 minutes to prevent the oxygen-deprived blood from returning to the heart suddenly.
When Emergency Medical Services (EMS) arrive onsite, ensure that they know to treat the rescued worker for possible suspension trauma. Inform them how long the worker was suspended.
Employers must plan for and practice fall rescue. Even if self-rescue is the primary plan, a fallen worker may not be able to perform self-rescue, so all workers using PFAS must be trained and prepared to perform assisted rescue.
Before a Fall
● All workers must be trained and prepared to perform assisted rescue.
● All staff should be taught that a 5-minute suspension in an upright position may be lethal.
● Workers should be instructed to push against any footholds and move their legs in the harness.
● Workers should be given hands-on instruction on how to hang in a harness and should make every effort to do so.
● Workers should not be permitted to work alone in a harness.
● Workers should have a way to signal for help, such as a whistle.
● The rescue plan and training should ensure that the rescue of a fall victim happens in less than 5 minutes.
After a fall
● Suspended workers should try to move their legs in the harness and try to push against any footholds, such as relief staps.
● If the worker is suspended upright, emergency measures must be taken to remove the worker from suspension or move the fallen worker into a horizontal posture or at least to a sitting position prior to the rescue.
● Rescuers must be aware that post-rescue death may happen if a victim is moved too rapidly to a horizontal position. Moving a worker too quickly to a horizontal position is likely to allow a large volume of used (deoxygenated) blood to move to the heart, causing cardiac arrest.
● Suspended workers should try to get their legs as high as possible and their heads as close to horizontal as possible.
● Rescuers must be aware of the first aid measures to prevent suspension trauma.
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