Suspension trauma

Before using fall protection equipment, it is important to develop a rescue plan. The availability of rescue equipment must be ensured, or it must be determined that the local rescue service has the capability to rescue from heights. The lack of a quick response in a rescue situation can lead to suspension trauma. Fall protection users and rescuers should:

  • Know whether the fall protection equipment they are using is properly adjusted and suitable to fulfill its purpose.
  • Recognize the symptoms of suspension trauma and its onset.
  • Be aware of factors that increase the risk of falling.
  • Know the correct rescue procedures and methods to reduce risks while suspended.

The cause of suspension trauma is remaining immobile in a vertical position for a certain period, such as fainting after standing in one place for a long time, or falling into a harness and being left hanging.

Symptoms of suspension trauma:

  • Faintness
  • Shortness of breath
  • Heavy sweating
  • Pallor
  • Feeling of heat
  • Nausea
  • Increased heart rate or significantly slowed heart rate
  • Extremely low blood pressure
  • Dizziness
  • Vision disturbances
  • Numbness in the legs

Why does suspension trauma occur?

When hanging in a harness, the leg straps support the body weight and compress the arteries in the legs, restricting blood flow. Blood begins to accumulate in the legs and does not circulate to the upper body, which forces the heart to work harder to supply the brain and vital organs with blood. The first symptoms include cold skin, rapid breathing, and a fast but weak pulse. As blood circulation decreases, blood pressure and pulse strength drop, and the lack of oxygen-rich blood in the brain leads to loss of consciousness. The lack of oxygen also affects other vital organs, and if the situation continues, it may result in death.

The extent of suspension trauma can also be influenced by other factors, such as shock from the fall, other injuries sustained during the fall, the fit and adjustment of the harness, environmental conditions, and the psychological state of the victim.

What to do after becoming trapped?

If the victim is conscious but unable to rescue themselves and the rescue operation is not immediate, the victim should try to move their legs as much as possible to restore blood circulation or use a trauma strap (a special strap attached to the harness to support body weight on the legs after a fall). Instead of a trauma strap, a regular rope with appropriate knots can also be used. It is important that the victim is able to maintain blood circulation until rescue arrives.

After losing consciousness, the victim should be rescued within 5 minutes. If the victim is unconscious and their brain does not receive enough oxygen, there is a high risk of brain damage. After 10 minutes, in addition to disturbances in organ systems, there can be severe brain damage, and death may occur in less than 30 minutes.

Using the trauma strap AY201: attach the trauma strap to the harness; pull the strap to extend it; adjust the strap length; place the foot in the trauma strap; for better support, use a separate strap for each leg.

To alleviate the risk of suspension trauma:

— always use a trauma strap with fall protection equipment;
— always prepare a rescue plan before performing work at heights;
— ensure that fall protection users have received appropriate training and education.

After the rescue

In the medical field, there is no consensus on whether the victim should be placed in a supine position or a “W” position after being rescued.

When the victim is in a horizontal position after rescue, blood circulates again. The blood that accumulated in the legs during the suspension had not received oxygen from the lungs and underwent anaerobic respiration, causing the blood to become acidic and toxic as glucose broke down. If the victim’s body is in a straight position, the toxic blood immediately returns to circulation and may cause organ and/or brain damage.

“W” position: The victim sits on the ground with a straight back and bent legs, so the knees are aligned with the chin, and the soles of the feet are firmly against the ground. In this position, the victim should remain for at least 30 minutes until symptoms begin to subside. In the “W” position, the toxic blood moves more slowly back into circulation, giving the body a better chance to filter the blood and maintain physiological balance. However, while in the “W” position, it takes longer for blood circulation to be restored to the brain, and the risk of brain damage remains.

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